PURPOSE: Lung carcinoids are rare, low grade malignant tumors. The "gold standard" treatment is surgical lung resection. Some authors support bronchoscopic treatment with a curative intent in selected carcinoid patients. We report our experience with endoscopic laser resection of endobronchial carcinoids.
METHODS: We included 25 patients (12 men and 13 women) with endobronchial carcinoids, treated with Nd:YAG laser with a curative intent at the Interventional Center, Rikshospitalet from 1998 to 2009. Median age was 39 years, range 23 - 80, median follow-up period was 3.5 years (range 1-11).
RESULTS: In total, 35 laser procedures were performed, 16 patients received only one procedure. Eleven patients (34%) were subsequently operated with lung resections (6 lobectomies, 4 bilobectomies, 1 pneumonectomy) due to suspected residual extrabronchial tumor tissue. In 3 of these patients no malignant tissue was detected in the resected lungs. All patients were yearly followed with bronchoscopy and CT thorax. All of them were alive and without malignant disease at the end of the observation period.One intraoperative complication was registered. Endobronchial combustion led to airway scarring and severe obstruction that caused recurrent lung infections. After repeated laser and balloon dilatation procedures the lung function improved to FEV1 74% predicted, and the lung infections subsided.
CONCLUSION: Endobronchial laser procedures are safe and complications are rare.
CLINICAL IMPLICATIONS: Selected patients with endobronchial carcinoids can be treated with laser ablation with a curative intent, although a significant proportion of the patients still require subsequent surgery.
DISCLOSURE: Kirill Neyman, No Financial Disclosure Information; No Product/Research Disclosure Information