Surgical Management and Survival Analysis of Pulmonary Carcinoid Tumors: A Three-Decade Perspective.

Pulmonary carcinoid tumors (PCTs), rare malignant neuroendocrine epithelial tumors constituting less than 1% of lung cancers, pose unique challenges in management. Surgical resection is the primary treatment modality, but consensus on the optimal approach remains elusive. This study aims to present the outcomes of surgical interventions for PCTs at the Thoracic and Cardiovascular Surgery Department of Habib Bourguiba University Hospital in Sfax, to assess postoperative survival, and to identify potential risk factors contributing to morbidity. The 33-year retrospective cohort study included all patients surgically treated for PCTs from 1989 to December 2022. Statistical analyses were conducted to uncover potential risk factors associated with morbidity and mortality. Over the study period, 21 patients underwent surgery for histologically confirmed PCTs. The sex ratio was 0.5, and the mean age was 45. Incidental discovery occurred in 14% of cases. Surgical procedures were performed via posterolateral thoracotomy, and the mean resections were: lobectomy (43%), bilobectomy (19%), and pneumonectomy (33%). Atypical carcinoids were present in 24% of cases. A higher percentage of T2-stage tumors (52%) suggested delayed medical attention before multidisciplinary discussion. Postoperative complications were noted for 57% of patients, with one death. Advanced age was significantly correlated with complications (p=0.006), and tumor location influenced their occurrence. This analysis underscores surgery's effectiveness in managing PCTs while highlighting significant morbidity factors. Prospective or multicenter studies are essential for a more comprehensive understanding of this rare pathology.