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(Chest. 2006;130:1405-1411.)
© 2006 American College of Chest Physicians

Bronchoscopic Cryotherapy Treatment of Isolated Endoluminal Typical Carcinoid Tumor*

Laurent Bertoletti, MD; Rami Elleuch, MD; David Kaczmarek, MD; Rita Jean-François, MD, FCCP{dagger} and Jean Michel Vergnon, MD, PhD{dagger}

* From the Departments of Pulmonary Diseases and Thoracic Oncology (Drs. Bertoletti, Elleuch, and Vergnon) and Thoracic and General Surgery (Dr. Kaczmarek), Hôpital Nord, St. Etienne University Hospital, Saint-Etienne, France; and the Department of Pulmonary Diseases (Dr. Jean-François), Hôpital Notre-Dame, University Hospital of Montreal, QC, Canada. {dagger} Drs. Jean-François and Vergnon are members of the French Speaking Group on Thoracic Endoscopy.

Correspondence to: Laurent Bertoletti, MD, Service de Pneumologie, Hôpital Nord, Centre Hospitalier de Saint-Etienne, 42000 Saint-Etienne, France; e-mail: lbertoletti{at}free.fr

Abstract

Background: Bronchial typical carcinoid tumors are rare. The "gold standard" treatment is surgery, but there is literature to support bronchoscopic therapy with curative intent. Based on the efficacy of cryotherapy for in situ lung cancer, we studied the safety and efficacy of rigid bronchoscopic treatment with cryotherapy on isolated endoluminal typical carcinoid tumors.

Methods: All the patients from the Department of Pulmonary Diseases and Thoracic Oncology of St. Etienne University Hospital (France), and of Hôpital Notre Dame, University Hospital of Montreal referred with typical carcinoid were screened. Inclusion criteria included the following: proven typical carcinoid, strictly endoluminal disease amenable to bronchoscopic therapy, and no evidence of lymph node invasion. All patients had a complete removal of the tumor, and all patients received cryotherapy to the implantation base.

Results: Twenty-nine patients were screened, and 18 were included. Mean age was 47 years, and study population included 11 women. Median follow-up was 55 months. There was a single recurrence 7 years after the initial bronchoscopic treatment.

Conclusions: Cryotherapy is a safe and effective adjunct to endobronchial mechanical resection of typical carcinoids. Unlike other adjuncts that have been proposed, cryotherapy is not associated with long-term complications including bronchial stenosis.

Key Words: bronchoscopy • carcinoid tumor • cryotherapy






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