Bronchial Adenoma Follow-up
- Author: Charles W Van Way III, MD; Chief Editor: Zab Mosenifar, MD more...
Further Outpatient Care
Chemotherapy and radiotherapy can be instituted if indicated, as discussed in Medical Care.
Transfer
If the endoscopist is not prepared to deal with airway bleeding, biopsy should be deferred until the patient has been sent to an appropriate facility.
Deterrence/Prevention
No preventive regimen has been established. Smoking cessation is always a good thing but has no specific effect on these tumors.
Complications
Perioperative complications include the following:
- Delayed hemorrhage
- Bronchial anastomotic leak
- Bleeding and coagulopathy
- Myocardial ischemia
- Atelectasis or pneumonia
- Respiratory failure, need for persistent mechanical ventilation
- Mucoepidermoid carcinoma - Known to result in intracranial metastases, even in cases of minimal bronchial wall involvement
- Carcinoid - Solid organ metastases (eg, to the liver) possible
Prognosis
The overall 5-year patient survival rates for bronchial adenomas are excellent at approximately 96%. Scattered reports describe local recurrences or distant metastases following adequate resection of typical lesions.
Carcinoids
The slow growth pattern of carcinoids often prolongs the natural history of the disease process. A 5-year patient survival rate of 92% and 10-year survival rate of 88% has been reported for typical carcinoids treated with complete resection and formal mediastinal dissection. These excellent results applied to patients with both N1 and N2 disease, although those with N2 status received adjunctive radiation therapy. In atypical carcinoids, the survival rate is decreased to 60% at 5 years and 49% at 10 years.
Adenoid cystic carcinoma
After resection, the 5-year survival rate is approximately 83% and the disease-free survival rate is 60%. Patients with adenoid cystic carcinoma have an excellent prognosis because the tumor grows slowly and is radiosensitive. The best results are achieved when complete resection is accomplished; however, prolonged patient survival is possible even with incomplete resection.
Mucoepidermoid carcinoma
The 5-year survival rate is 11.1%. This tumor is known to cause intracranial metastases, even in the presence of minimal bronchial wall involvement. Chemotherapy and radiation are used mainly for palliation.
Patient Education
For excellent patient education resources, visit eMedicine's Procedures Center. In addition, see eMedicine's patient education article Bronchoscopy.
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