TY - JOUR
T1 - Morbidity and extent of surgical resection of carcinoid tumors after endobronchial treatment
AU - Reuling, E. M. B. P.
AU - Naves, D. D.
AU - Hartemink, K. J.
AU - van der Heijden, E. H. F. M.
AU - Plaisier, P. W.
AU - Verhagen, A. F. T. M.
AU - Daniels, J. M. A.
AU - Dickhoff, C.
N1 - Funding Information: ER, CD and JD were responsible for the conception and design of the study and acquisition of data. CD, KH, AV participated as surgical panel. ER and DN performed analysis and interpretation of the data. The article has been written by ER and critically revised by the authors who all gave approval for submission. Each author has participated sufficiently in the contributions of this article and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. This study was supported by a grant of ORAS (Oncological Research Albert Schweitzer Hospital) . Publisher Copyright: © 2021 The Authors
PY - 2021/12
Y1 - 2021/12
N2 - Objectives: This study assessed whether endobronchial therapy (EBT) for bronchial carcinoid, if not curative, reduces the extent of the surgical resection and whether EBT is associated with increased surgical morbidity. Material and methods: Analysis was performed in a cohort of patients with bronchial carcinoid who have undergone surgical resection. A group that underwent EBT before the surgery (S + EBT) was compared with a group where no EBT was performed (S-EBT). Postoperative complications were also compared between both groups. Results: A total of 254 patients treated for a bronchial carcinoid tumor between 2003 and 2019 were screened for inclusion. A total of 65 surgically treated patients were included, of whom 41 (63%) underwent EBT prior to surgery. In 5 out of 41 patients (12%) from the S + EBT group, less parenchyma was resected versus 2 out of 24 (8%) from the S-EBT group (OR 1.528, 95% CI 0.273–8.562, p = 1.000). Two patients from the S + EBT group (5%) underwent lobectomy instead of sleeve lobectomy versus 0 from the S-EBT group (OR 1.051, 95% CI 0.981–1.127, p = 0.527). Comparing complications between the S + EBT and S-EBT group did not result in increased postoperative surgical morbidity (15% S + EBT, 24% S-EBT). Conclusion: EBT, if not curative, does not reduce the extent of the subsequent surgical resection. Therefore, if curative EBT is not anticipated, patients should directly be referred for surgery. If curative EBT seems feasible, it should be attempted not only because surgical resection can be prevented, but also because failure of EBT is not associated with excess surgical morbidity.
AB - Objectives: This study assessed whether endobronchial therapy (EBT) for bronchial carcinoid, if not curative, reduces the extent of the surgical resection and whether EBT is associated with increased surgical morbidity. Material and methods: Analysis was performed in a cohort of patients with bronchial carcinoid who have undergone surgical resection. A group that underwent EBT before the surgery (S + EBT) was compared with a group where no EBT was performed (S-EBT). Postoperative complications were also compared between both groups. Results: A total of 254 patients treated for a bronchial carcinoid tumor between 2003 and 2019 were screened for inclusion. A total of 65 surgically treated patients were included, of whom 41 (63%) underwent EBT prior to surgery. In 5 out of 41 patients (12%) from the S + EBT group, less parenchyma was resected versus 2 out of 24 (8%) from the S-EBT group (OR 1.528, 95% CI 0.273–8.562, p = 1.000). Two patients from the S + EBT group (5%) underwent lobectomy instead of sleeve lobectomy versus 0 from the S-EBT group (OR 1.051, 95% CI 0.981–1.127, p = 0.527). Comparing complications between the S + EBT and S-EBT group did not result in increased postoperative surgical morbidity (15% S + EBT, 24% S-EBT). Conclusion: EBT, if not curative, does not reduce the extent of the subsequent surgical resection. Therefore, if curative EBT is not anticipated, patients should directly be referred for surgery. If curative EBT seems feasible, it should be attempted not only because surgical resection can be prevented, but also because failure of EBT is not associated with excess surgical morbidity.
KW - Atypical carcinoid
KW - Endobronchial therapy
KW - Thoracic surgery
KW - Typical carcinoid
UR - http://www.scopus.com/inward/record.url?scp=85106658775&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ejso.2021.05.025
DO - https://doi.org/10.1016/j.ejso.2021.05.025
M3 - Article
C2 - 34039475
SN - 0748-7983
VL - 47
SP - 2989
EP - 2994
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 12
ER -