Abstract
The authors discuss the diagnosis of recurrent bronchial carcinoids after previous resection. The aim was to de-termine an optimal approach to follow-up of these patients based on identified risk factors.
Methods and patients: A retrospective analysis of results from follow-up of patients after resection of broncho-genic carcinoid tumors. We analyzed patients' diagnostic characteristics, types of surgery, types of tumors and re-currences.
Presented are three selected case reports of patients treated for recurrence of their disease. Results: Between 1998 and 2016, a total of 52 patients were diagnosed with and operated for bronchial carci-noids in our center.
The sample comprised 23 males and 29 females of middle age (median age 59 years; range 17-84 years). Of those, 45 had typical carcinoids, six had atypical carcinoids and one had mixed carcinoid.
Lo-bectomy/bilobectomy was performed in 44 patients, segmentectomy in one, bronchial resection in two, segmental resection in two and cryodestruction in three patients. Recurrences were found in six patients, of whom four had previous lobectomy, one had segmentectomy and one had cryodestruction.
Typical and mixed carcinoids recurred in five and one cases, respectively. Discussion: Since there are no accurate official international guidelines, an effort was made to summarize all possible means for the follow-up of these patients and propose a suitable strategy for care in this paper.
The op-timal approach seems to involve regular outpatient check-ups including the 5-HIAA laboratory tests and bronchial fibroscopy twice a year postoperatively and, later, once a year or as needed based on laboratory screening. Addi-tionally, annual CT and ultrasound scans are recommended.
In case of significant suspicion, an octreotide scan is performed. To a certain extent, however, the plan should be individualized.
Conclusion: Lung carcinoids are tumors with low malignant potential. The prognosis of patients after radical resections without adjunctive therapy is usually very good.
However, patients need long-term postoperative fol-low-up. Although relatively low recurrence rates are generally reported, the rate in our sample was 11.5 %.
Even in case of recurrence, other effective treatment options may be considered.