Dr. Christophe L. Nguyen

Lead researcher Christophe L. Nguyen, MD, Surgical Oncologist, Fox Chase Cancer Center, Philadelphia, Pennsylvania, United States, and colleagues conducted a study to review the histopathologic differences and surgical management of typical and atypical carcinoid tumors.

"Furthermore, such a review would allow us to assess the reliability of preoperative biopsy and frozen section in the diagnosis of atypical carcinoid tumors," Dr. Nguyen explained.

Preoperative biopsies could not differentiate with certainty typical from atypical carcinoids, Dr. Nguyen said.

"Frozen section biopsies failed to identify atypical carcinoids in our series," he said.
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"This differentiation is important," Dr. Nguyen said, "as atypical carcinoids have a greater tendency to metastasize locally to lymph nodes and to distant sites."
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Although most studies support performing a complete anatomical resection with mediastinal lymph node dissection for atypical carcinoids, the surgical treatment of typical carcinoids remains controversial, Dr. Nguyen said.

"Indeed, some authors recommend parenchyma-sparing resections rather than formal resections in these tumors," he said."However, deciding on the appropriate operative strategy can be difficult, as preoperative biopsies and intraoperative frozen section diagnosis may be inaccurate."

In contrast to the typical variant, atypical bronchial carcinoids have a worse prognosis with a higher rate of recurrence and worse overall 5-year survival, Dr. Nguyen said.

[Presentation title: Bronchial Carcinoid Tumors: Tumor Histopathology and Surgical Management.Abstract P-200]