Treatment of pulmonary carcinoid: Are there new options?

INTRODUCTION Pulmonary carcinoid represents 3% of lung neoplasms. Although surgical resection is the gold standard, endoscopic techniques may offer an alternative in selected cases. METHODS Retrospective study of all patients diagnosed with carcinoid tumor (1999-2013) at a terciary hospital. The epidemiology, clinical parameters, treatment type and overall survival were evaluated. RESULTS 96 patients recruited. 63 had a smoking history>10 P-Y. Time from symptom onset to diagnosis: 13.69+/-11.64 months. Clinical features at presentation: recurrent pneumonia (n=36, 37.5%), cough (n=29, 30.2%), hemoptysis (n=16, 16.6%). 22 patients were asymptomatic (22.9%). The most common location: right upper lobe (n=24, 25%). Most frequent histology: typical type (n=81, 84.3%). 8 patients were managed conservatively. 3 tumor-related deaths: all with atypical histology and conservative treatment. Overall 5-year survival: 94.6%. For those treated endoscopically: 100%, for those receiving surgery: 97.8%. CONCLUSIONS Pulmonary carcinoid has generally a good prognosis. The treatment of choice is surgery, but in selected cases, endoscopic resection may be a good alternative, with comparable results to surgery.