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Khirurgii

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Year 2023 Vol. 31 No 5

SCIENTIFIC PUBLICATIONS

M.YU. PIKUNOV 1, A.A. PECHETOV 1, O.O. GOLOUNINA 2, E.V. BONDARENKO 2, Z.E. BELAYA 2

SURGICAL TREATMENT OF PATIENTS WITH ACTH-PRODUCING NEUROENDOCRINE TUMOR OF BRONCHOPULMONARY LOCALIZATION: THE EXPERIENCE OF NATIONAL MEDICAL RESEARCH CENTER FOR SURGERY NAMED AFTER A.V. VISHNEVSKY

National Medical Research Center of Surgery named after A. V. Vishnevsky of the Ministry of Health of the Russian Federation 1,
National Medical Research Center for Endocrinology 2, Moscow,
Russian Federation

Objective. To create a methodological scheme for effective surgical treatment of patients with bronchopulmonary ACTH-producing neuroendocrine tumors (NET), varying severity of hypercortisolism, with minimal risk of early postoperative complications.
Methods. The study included patients who underwent examination and surgical treatment of ACTH-producing NET of bronchopulmonary localization in the period from 2004 to August 2023. Demographic information about patients, anamnesis data, results of hormonal and instrumental studies at pre- and postoperative stages, long-term treatment results have been analyzed. The control follow-up period after surgery ranged from 6 months to 5 years.
Results. The study included 74 patients. The age at the time of diagnosis of the disease ranged from 21 to 76 years, in an almost equal ratio of men and women. Due to the severity of the condition, 3 patients were denied surgical treatment. 71 patients underwent surgery. Atypical lung resection was performed (n=27 (38%)), segmentectomy (n=19 (26.8%)), lobectomy (n=25 (35.2%)) with a radicality index of R0. Typical carcinoid was verified in 48 patients (67.6%), atypical carcinoid – in 23 (23.4%). Single metastases in remote mediastinal lymph nodes were detected in 8 patients. A decrease in blood cortisol 60 minutes after the removal of the tumor was noted in 90% of patients. No postoperative complication was reported. Repeated surgical intervention for 6 patients was performed after 12-36 months of follow-up. 60 months of follow-up later it was possible to obtain data from 46 patients. The lethality was 5 patients.
Conclusion. In the surgical treatment of patients with ACTH-producing pulmonary NET it is necessary to be guided by the scale of condition severity assessment, the data of radiation diagnostics, preoperative possible verification to select an adequate volume of surgical intervention. The analysis of this experience of surgical treatment does not differ from the indicators in other world clinics. Its advantage include the absence of postoperative complications.

Keywords: ectopic ACTH-syndrome (EAS); neuroendocrine tumor (NET); hypercortisolism; bronchial carcinoid; surgical treatment; long-term results
p. 362-373 of the original issue
References
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Address for correspondence:
115093, Moscow, Russian Federation,
Bolshaya Serpukhovskaya, st. 27,
National Medical
Surgery Research Center,
Named after A.V. Vishnevsky,
e-mail: pikunov@ixv.ru,
Pikunov Mikhail Y.
Information about the authors:
Pikunov Mikhail Y., PhD, leading researcher at the Department of Thoracic Surgery, National Medical Research Center for Surgery named after. A.V. Vishnevsky» of the Russian Ministry of Health of Russian Federation. Moscow, Russian Federation.
http://orcid.org/0000-0003-0559-4461
Pechetov Alexey A., PhD, Head of the Department of Thoracic Surgery, National Medical Research Center for Surgery named after. A.V. Vishnevsky» of the Russian Ministry of Health of Russian Federation. Moscow, Russian Federation.
http://orcid.org/0000-0002-1823-4396
Golounina Olga O., Clinical Resident of the State Scientific Center of the Russian Federation, Federal State Budgetary Institution «National Medical Research Center for Endocrinology» of the Ministry of Health of Russian Federation. Moscow, Russian Federation.
https://orcid.org/0000-0003-2320-1051
Bondarenko Ekaterina V., PhD, Head of the Biobanking Group of the State Research Center of the Russian Federation, Federal State Budgetary Institution «National Medical Research Center for Endocrinology» of the Ministry of Health of Russian Federation. Moscow, Russian Federation.
https://orcid.org/0000-0003-2122-2297
Belaya Zhanna E., MD, Head of the Department of Neuroendocrinology and Osteopathy, Professor of the Department of Endocrinology of the Institute of Higher and Additional Professional Education of the State Scientific Center of the Russian Federation, Federal State Budgetary Institution «National Medical Research Center for Endocrinology» of the Ministry of Health of Russian Federation, Moscow, Russian Federation.
http://orcid.org/0000-0002-6674-6441
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