Surgical Management of Primary Pulmonary Carcinoid Tumors

Objective Primary pulmonary carcinoid tumors constitute 1% to 2% of primary lung neoplasms, with limited surgical outcome data due to the rarity of these neoplasms. The aim of our study was to review the complications and long-term outcomes following surgery for primary pulmonary carcinoid neoplasms. Methods With institutional review board approval, the charts of patients with lung neoplasms from 2000-2022 were reviewed. In total, 605 total charts were reviewed, with 535 excluded for not having a primary pulmonary carcinoid tumor or not receiving surgical treatment. Typical, atypical, and cumulative survival rates were calculated along with complications. Results Major presenting symptoms included 31% (n = 22) persistent cough, 30% (n = 21) dyspnea, 9% (n = 6) hemoptysis, and 7% (n = 5) constitutional symptoms (fever, weight loss, and/or night sweats). Fifty-one percent (n = 36) were found incidentally, and 14% (n = 10) had unknown presentation. There were complications in 26 patients (41%). Minor complications included chest wall pain (n = 6), chest tube air leak (n = 4), dyspnea (n = 3), atelectasis (n = 2), ileus (n = 2), postpneumonectomy syndrome (n = 1), and chronic cough (n = 1). Serious complications included atrial fibrillation (n = 2), respiratory failure (n = 1), hemothorax (n = 1), hypovolemic shock (n = 1), and intraoperative tension pneumothorax (n = 1). No patients died during surgery or secondary to any complications of surgery. Outcomes The cumulative 2-year survival rate was 98.5%, and the cumulative 5-year survival rate was 96.3%. There were seven total deaths during the study period, but the cause of death was not reported. Conclusions This study confirms that resection of primary pulmonary carcinoid tumors is relatively low risk, with excellent long-term survival rates.