Significance of the resection margin in bronchopulmonary carcinoids

• Published in: The Journal of surgical research 2016-03, Vol.201 (1), p.53-58
• Main Authors: Schmid, Severin, MD, Aicher, Michael, cand.med, Csanadi, Agnes, MD, PhD, Passlick, Bernward, MD, PhD, Kaifi, Jussuf Thomas, MD, PhD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Atypical carcinoid; Carcinoid Tumor - mortality; Carcinoid Tumor - surgery; Female; Germany - epidemiology; Humans; Lung Neoplasms - mortality; Lung Neoplasms - surgery; Male; Middle Aged; Neoplasm Recurrence, Local - epidemiology; Pulmonary carcinoids; Recurrence; Resection margin; Retrospective Studies; Surgery; Typical carcinoid
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2015.09.036

Abstract Background Complete surgical resection is the treatment of choice in bronchopulmonary carcinoids. Previously published data showed no inferiority of sublobar versus lobar resection. Data on the length of resection margins are lacking; thus, we aimed to analyze resection margins in pulmonary carcinoids and correlated them with survival and recurrence. Methods We retrospectively analyzed 85 patients who underwent surgery for atypical (AC) or typical (TC) pulmonary carcinoids. Patient charts were reviewed, and clinicopathologic and survival data were collected. Pathology reports were reviewed for length of resection margins. Results The median follow-up period was 42.3 mo (range, 0.3–172.2). There was no statistically significant difference in disease-free survival (DFS) when comparing resection margins ≤2 mm to >2 mm ( P  = 0.93, hazard ratio = 1.7). When looking at AC alone, a worse DFS can be seen if the resection margin was smaller than 2 mm ( P  = 0.06, hazard ratio = 15.8). In AC, likelihood of recurrence was higher when the resection margin was ≤1 cm (odds ratio = 5.1, P  = 0.28). In TC, this tendency was not present (odds ratio = 1.2, P  = 1). Conclusions There is a trend toward a worse prognosis and higher likelihood of recurrence in smaller resection margins in AC in contrast to TC. Owing to low sample size, no definitive statements can be made based on this study; however, respective data on these rare tumors cannot be drawn from tumor databases. The resection margin is one of the critical issues for the treating surgeon, and any information on this topic is of highest importance to the field.