Experiencia institucional en México en el manejo quirúrgico de tumores carcinoides pulmonares
Armas-Zárate, Francisco Javier1; Valencia-Sánchez, Liliana Denisse1; Iñiguez-García, Marco Antonio1
Armas-Zárate, Francisco Javier1; Valencia-Sánchez, Liliana Denisse1; Iñiguez-García, Marco Antonio1
RESUMEN
PALABRAS CLAVE
Tumor carcinoide pulmonar, cirugía, tumor neuroendocrino.REFERENCIAS
Eberhardt WE, Mitchell A, Crowley J, Kondo H, Kim YT, Turrisi A 3rd, et al. The IASLC lung cancer staging project: proposals for the revision of the m descriptors in the forthcoming eighth edition of the TNM classification of lung cancer. J Thorac Oncol. 2015;10(11):1515-22. doi: 10.1097/JTO.0000000000000673.
Caplin ME, Baudin E, Ferolla P, Filosso P, Garcia-Yuste M, Lim E, et al. Pulmonary neuroendocrine (carcinoid) tumors: European Neuroendocrine Tumor Society expert consensus and recommendations for best practice for typical and atypical pulmonary carcinoids. Ann Oncol. 2015;26(8):1604-1620. doi: 10.1093/annonc/mdv041.
Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WE, et al. The IASLC lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (Eighth) edition of the TNM classification for lung cancer. J Thorac Oncol. 2016;11(1):39-51. doi: 10.1016/j.jtho.2015.09.009.
Table 1: Description of patient population. |
|
Demograph feature |
n (%) |
Gender Female Male |
20 (66) 10 (33) |
Age (average) (years) Hospital stay (media) (days) Smoking Arterial hypertension Diabetes mellitus |
47.2 20 15 (50) 9 (30) 4 (16) |
Presentation symptoms* Dyspnea Hemoptoic Cough with expectation Weight loss Thoracic pain |
12 (40) 12 (40) 9 (30) 7 (23) 6 (20) |
Follow (media) (months) |
21.9 |
* Most patients had more than one symptom, the predominant one was considered. |
Table 2: Anatomical and histopatological description. |
|
Location |
n (%) |
Right Upper lobe Middle lobe Lower lobe Main bronchus Superimposed in 2 lobes |
21 (70) 6 (20) 6 (20) 3 (10) 3 (10) 3 (10) |
Left Upper lobe Lower lobe Main bronchus |
9 (30) 0 6 (20) 3 (10) |
Histopathology Typical carcinoid Atypical carcinoid |
18 (60) 12 (40) |
Tumoral size < 2 cm 2-4 cm < 4 cm |
7 (23) 13 (43) 10 (33) |
Ganglionar involvement No Yes No nodes examined |
22 (73) 4 (13) 4 (13) |
Table 3: Surgical description. |
|
Approach |
n (%) |
Thoracotomy VATS VATS with conversion to thoracotomy |
19 (63) 5 (16) 6 (20) |
Procedure Lobectomy Pneumonectomy Bilobectomy Sleeve resection Lobectomy + bronchoplasty |
15 (50) 6 (20) 2 (6) 2 (6) 5 (16) |
Complications Bleeding Pneumonia Fistula broncopleural |
7 (30) 4 (13) 2 (6) 1 (3) |
Adyuvance Mortality at 30 days |
4 (13) 0 (0) |
VATS = Video-assisted thoracoscopic surgery. |
Table 4: Staging according to TNM 8th edition.31 |
|
Estadio |
n (%) |
IA1 |
1 (3) |
IA2 |
7 (23) |
IA3 |
6 (20) |
IB |
5 (16) |
IIA |
3 (10) |
IIB |
3 (10) |
IIIA |
4 (13) |
IIIB |
1 (3) |
IIIC |
0 (0) |
IVA |
0 (0) |
IVB |
0 (0) |
TNM= Tumor, nodes, metastasis. |