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D. Jain

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    Poster Display session (Friday) (ID 65)

    • Event: ELCC 2018
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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      225P - Surgical experience of advanced bronchopulmonary carcinoids: An analysis from a tertiary care hospital of North India (ID 372)

      12:30 - 13:00  |  Author(s): D. Jain

      • Abstract

      Bronchopulmonary carcinoid is an uncommon, distinct malignant potential lung cancer. Surgery is the mainstay of treatment. The aim of this study was to analyze the epidemiology, complex surgical approaches and their outcomes.

      This was a retrospective study done in the Department of Surgical Oncology of a tertiary teaching institute of North India. All the case records were analyzed for clinical case history, preoperative treatment, surgical procedures, postoperative events, adjuvant treatment, histopathology and outcome.

      A total of 30 patients who were operated on from 2012 to 2017 for bronchopulmonary carcinoids were reviewed. The mean age was 36 years with male predominance. 50% had a history of a cough and hemoptysis. Four patients were smokers. Six patients had been treated for tuberculosis and one patient received neoadjuvant chemotherapy due to histopathological misdiagnosis. One-third of patients had underlying pneumonia. Bronchoscopy-guided intraluminal tumor debulking was done in 5 cases to treat obstructive pneumonia before taking up for surgery. Ten pneumonectomies (including carinoplasty with latissimus dorsi muscle cover in three patients) were performed in patients with tumor in the main bronchus with extrabronchial spread. Other operative procedures included 13 bilobectomies, 7 lobectomies, bronchoplastic procedures in 4 patients (1 in bilobectomy and 3 in lobectomy). Postoperative mortality was nil; 6 patients had lobar collapse, high ICD output (conservatively treated) and surgical site infection postoperatively. In histopathology, 21 had typical and 9 had atypical carcinoids and all were margin negative except one. Two patients had lymph node metastasis and adjuvant chemotherapy was given to both. With the median follow-up of 22 months, all the patients are disease-free and doing well.

      Diagnostic dilemma and late presentation are major concerns in India. Aggressive surgical procedures including sleeve resection with bronchoplasty may be needed to achieve margin-negative resection because of good prognosis and long-term survival. In some cases bronchoscopic debulking can be done preoperatively to optimize the patients.

      Clinical trial identification:

      Legal entity responsible for the study:
      All India Institute of Medical Science

      Has not received any funding

      All authors have declared no conflicts of interest.