Endobronchial Treatment for Bronchial Carcinoid: Patient Selection and Predictors of Outcome

Ellen M B P Reuling, Chris Dickhoff, Peter W Plaisier, Veerle M H Coupé, Albert H A Mazairac, Rutger J Lely, H Jaap Bonjer, Johannes M A Daniels

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Traditionally, surgical resection is the preferred treatment for typical carcinoids and atypical carcinoids located in the lungs. Recently however, several studies have shown excellent long-term outcome after endobronchial treatment of carcinoid tumors located in the central airways. This study investigates clinical and radiological features as predictors of successful endobronchial treatment in patients with a bronchial carcinoid tumor.

OBJECTIVES: To identify clinical and radiological features predictive of successful endobronchial treatment in patients with bronchial carcinoid.

METHODS: This analysis was performed in a cohort of patients with typical and atypical bronchial carcinoid referred for endobronchial treatment. Several patient characteristics, radiological features, and histological grade (typical or atypical carcinoid) were tested as predictors of successful endobronchial treatment.

RESULTS: One hundred and twenty-five patients with a diagnosis of bronchial carcinoid underwent endobronchial treatment. On multivariate analysis, a tumor diameter <15 mm (odds ratio 0.09; 95% confidence interval 0.02-0.5; p = <0.01) and purely intraluminal growth on computer tomography (CT scan) (odds ratio, 9.1; 95% confidence interval 1.8-45.8; p = <0.01) were predictive of radical endobronchial treatment. The success rate for intraluminal tumors with a diameter <20 mm was 72%.

CONCLUSIONS: Purely intraluminal disease and tumor diameter on CT scan seem to be independent predictors for successful endobronchial treatment in patients with bronchial carcinoid. Based on these data, patients with purely intraluminal carcinoid tumors with a diameter <20 mm on CT scan are good candidates for endobronchial treatment, regardless of histological grade. In contrast, all patients with a tumor diameter ≥20 mm should be directly referred for surgery.

LanguageEnglish
Pages220-227
Number of pages8
JournalRespiration
Volume95
Issue number4
DOIs
Publication statusPublished - 13 Feb 2018

Cite this

@article{79b6e61e79854a82af620e170d84ad29,
title = "Endobronchial Treatment for Bronchial Carcinoid: Patient Selection and Predictors of Outcome",
abstract = "BACKGROUND: Traditionally, surgical resection is the preferred treatment for typical carcinoids and atypical carcinoids located in the lungs. Recently however, several studies have shown excellent long-term outcome after endobronchial treatment of carcinoid tumors located in the central airways. This study investigates clinical and radiological features as predictors of successful endobronchial treatment in patients with a bronchial carcinoid tumor.OBJECTIVES: To identify clinical and radiological features predictive of successful endobronchial treatment in patients with bronchial carcinoid.METHODS: This analysis was performed in a cohort of patients with typical and atypical bronchial carcinoid referred for endobronchial treatment. Several patient characteristics, radiological features, and histological grade (typical or atypical carcinoid) were tested as predictors of successful endobronchial treatment.RESULTS: One hundred and twenty-five patients with a diagnosis of bronchial carcinoid underwent endobronchial treatment. On multivariate analysis, a tumor diameter <15 mm (odds ratio 0.09; 95{\%} confidence interval 0.02-0.5; p = <0.01) and purely intraluminal growth on computer tomography (CT scan) (odds ratio, 9.1; 95{\%} confidence interval 1.8-45.8; p = <0.01) were predictive of radical endobronchial treatment. The success rate for intraluminal tumors with a diameter <20 mm was 72{\%}.CONCLUSIONS: Purely intraluminal disease and tumor diameter on CT scan seem to be independent predictors for successful endobronchial treatment in patients with bronchial carcinoid. Based on these data, patients with purely intraluminal carcinoid tumors with a diameter <20 mm on CT scan are good candidates for endobronchial treatment, regardless of histological grade. In contrast, all patients with a tumor diameter ≥20 mm should be directly referred for surgery.",
keywords = "Adolescent, Adult, Aged, Aged, 80 and over, Bronchial Neoplasms/mortality, Bronchoscopy/statistics & numerical data, Carcinoid Tumor/mortality, Female, Humans, Male, Middle Aged, Netherlands/epidemiology, Retrospective Studies, Young Adult",
author = "Reuling, {Ellen M B P} and Chris Dickhoff and Plaisier, {Peter W} and Coup{\'e}, {Veerle M H} and Mazairac, {Albert H A} and Lely, {Rutger J} and Bonjer, {H Jaap} and Daniels, {Johannes M A}",
note = "{\circledC} 2018 S. Karger AG, Basel.",
year = "2018",
month = "2",
day = "13",
doi = "10.1159/000484984",
language = "English",
volume = "95",
pages = "220--227",
journal = "Respiration",
issn = "0025-7931",
publisher = "S. Karger AG",
number = "4",

}

Endobronchial Treatment for Bronchial Carcinoid : Patient Selection and Predictors of Outcome. / Reuling, Ellen M B P; Dickhoff, Chris; Plaisier, Peter W; Coupé, Veerle M H; Mazairac, Albert H A; Lely, Rutger J; Bonjer, H Jaap; Daniels, Johannes M A.

In: Respiration, Vol. 95, No. 4, 13.02.2018, p. 220-227.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Endobronchial Treatment for Bronchial Carcinoid

T2 - Respiration

AU - Reuling, Ellen M B P

AU - Dickhoff, Chris

AU - Plaisier, Peter W

AU - Coupé, Veerle M H

AU - Mazairac, Albert H A

AU - Lely, Rutger J

AU - Bonjer, H Jaap

AU - Daniels, Johannes M A

N1 - © 2018 S. Karger AG, Basel.

PY - 2018/2/13

Y1 - 2018/2/13

N2 - BACKGROUND: Traditionally, surgical resection is the preferred treatment for typical carcinoids and atypical carcinoids located in the lungs. Recently however, several studies have shown excellent long-term outcome after endobronchial treatment of carcinoid tumors located in the central airways. This study investigates clinical and radiological features as predictors of successful endobronchial treatment in patients with a bronchial carcinoid tumor.OBJECTIVES: To identify clinical and radiological features predictive of successful endobronchial treatment in patients with bronchial carcinoid.METHODS: This analysis was performed in a cohort of patients with typical and atypical bronchial carcinoid referred for endobronchial treatment. Several patient characteristics, radiological features, and histological grade (typical or atypical carcinoid) were tested as predictors of successful endobronchial treatment.RESULTS: One hundred and twenty-five patients with a diagnosis of bronchial carcinoid underwent endobronchial treatment. On multivariate analysis, a tumor diameter <15 mm (odds ratio 0.09; 95% confidence interval 0.02-0.5; p = <0.01) and purely intraluminal growth on computer tomography (CT scan) (odds ratio, 9.1; 95% confidence interval 1.8-45.8; p = <0.01) were predictive of radical endobronchial treatment. The success rate for intraluminal tumors with a diameter <20 mm was 72%.CONCLUSIONS: Purely intraluminal disease and tumor diameter on CT scan seem to be independent predictors for successful endobronchial treatment in patients with bronchial carcinoid. Based on these data, patients with purely intraluminal carcinoid tumors with a diameter <20 mm on CT scan are good candidates for endobronchial treatment, regardless of histological grade. In contrast, all patients with a tumor diameter ≥20 mm should be directly referred for surgery.

AB - BACKGROUND: Traditionally, surgical resection is the preferred treatment for typical carcinoids and atypical carcinoids located in the lungs. Recently however, several studies have shown excellent long-term outcome after endobronchial treatment of carcinoid tumors located in the central airways. This study investigates clinical and radiological features as predictors of successful endobronchial treatment in patients with a bronchial carcinoid tumor.OBJECTIVES: To identify clinical and radiological features predictive of successful endobronchial treatment in patients with bronchial carcinoid.METHODS: This analysis was performed in a cohort of patients with typical and atypical bronchial carcinoid referred for endobronchial treatment. Several patient characteristics, radiological features, and histological grade (typical or atypical carcinoid) were tested as predictors of successful endobronchial treatment.RESULTS: One hundred and twenty-five patients with a diagnosis of bronchial carcinoid underwent endobronchial treatment. On multivariate analysis, a tumor diameter <15 mm (odds ratio 0.09; 95% confidence interval 0.02-0.5; p = <0.01) and purely intraluminal growth on computer tomography (CT scan) (odds ratio, 9.1; 95% confidence interval 1.8-45.8; p = <0.01) were predictive of radical endobronchial treatment. The success rate for intraluminal tumors with a diameter <20 mm was 72%.CONCLUSIONS: Purely intraluminal disease and tumor diameter on CT scan seem to be independent predictors for successful endobronchial treatment in patients with bronchial carcinoid. Based on these data, patients with purely intraluminal carcinoid tumors with a diameter <20 mm on CT scan are good candidates for endobronchial treatment, regardless of histological grade. In contrast, all patients with a tumor diameter ≥20 mm should be directly referred for surgery.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Bronchial Neoplasms/mortality

KW - Bronchoscopy/statistics & numerical data

KW - Carcinoid Tumor/mortality

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Netherlands/epidemiology

KW - Retrospective Studies

KW - Young Adult

U2 - 10.1159/000484984

DO - 10.1159/000484984

M3 - Article

VL - 95

SP - 220

EP - 227

JO - Respiration

JF - Respiration

SN - 0025-7931

IS - 4

ER -