Primary Pulmonary Carcinoid Tumor

Purpose/Objective(s): Carcinoid tumors of the lung are rare tumors which comprise approximately 1 to 2% of all lung malignancies in adults and roughly 20 to 30% of all carcinoid tumors. In addition, little is known about the etiology of these tumors and unlike most lung cancers, no external environmental toxin has been clearly identified as a causative agent. In this retrospective study, we report the history of primary pulmonary carcinoid tumor and a single institution experience.Materials/Methods: We conducted a retrospective study in patients with a diagnosis of carcinoid tumor treated at the Huntsman Cancer Hospital, University of Utah. We identified 35 patients diagnosed with primary pulmonary carcinoid tumor from 1989 to 2009. We obtained patient data from the Huntsman Cancer Institute Tumor Registry and directly from chart abstraction. Kaplan-Meier curves were drawn and used to calculate disease free survival and overall survival in our study patients.Results: Of 35 patients, there were 22 males and 13 females with an average age of 51 years (range 24-77) at diagnosis. Five out of 35 patients (14.3%) had atypical carcinoids, and the remaining 30 patients (85.7%) had typical carcinoids. Only 4 of 35 (11.4%) patients presented with typical carcinoid syndrome while 31 (88.6%) had non-carcinoid presentations or incidental findings (n=10). Twenty-five (71.4%) patients had a history of tobacco use. The median tumor size was 2.0 cm (range 0.9 - 6 cm). Of the 21 patients presenting with non-carcinoid symptoms, dyspnea and hemoptysis were each reported in 8 patients and persistent cough was seen in 6. Tumors were located at or proximal to the bronchus intermedius in 10 patients (28.6%) while 25 (71.4%) had tumors distal to this site. All patients received surgical treatment, consistent with lobectomy (n=23), wedge/segmental or a less than lobectomy (n=10), and pneumonectomy (n=1). In addition to surgery, 3 out of 35 patients received adjuvant chemotherapy and radiation therapy for atypical carcinoid tumors. Median follow-up time was 72.8 months (range 0.2-256.5 months), and only one patient had persistent disease while the remaining 34 patients had no recurrent or metastatic disease. The Kaplan-Meier 2-, 5-, and 10-year overall survivals and disease-free survivals were 94%, 89% and 86%, and 94%, 87%, and 87%, respectively.Conclusions: Most primary pulmonary carcinoid tumors demonstratednon-classic clinical presentations. Surgical resection was primary and adequate therapy for most carcinoid tumors. Overall survival and disease-free survival rates were very high in our long term follow-ups. Adjuvant chemotherapy or radiotherapy was reserved for patients with atypical carcinoid tumors and adverse pathological findings.

MSRO22-08

Primary Pulmonary Carcinoid Tumor