The improvement in awareness, the recent radiological techniques advancement, and the accumulating experience on diagnosis of small, peripheral pulmonary nodules (especially through the lung cancer screening programs, which was dramatically increased worldwide), along with the tremendous diffusion of immunohistochemistry in the pathological diagnosis of lung neoplasms, made a sensible growing of thoracic neuroendocrine tumor (TNT) diagnosis possible, in the last decades. The interest to TNTs management has never been so strong as in the last few years. Several articles concerning biology, associated paraneoplastic syndromes, surgery, imaging, follow-up schedule, new drugs available both in induction and/or in adjuvant setting, have been recently published.
Lung Neuroendocrine dedicated working-groups [e.g., that from the European Society for Thoracic Surgery (ESTS)] have been also lately created with the aim to assemble expert physicians on this field, improving knowledge on such rare neoplasms, disseminating it to the scientific community and, possibly, create International guidelines on their treatment.
If it is true, in fact, that surgery represents the mainstay of treatment for the great majority of low-intermediate grade TNTs, the optimal therapeutical approach for high grade and/or advance diseases is still matter of debate.
This is the reason why, in close cooperation with the Journal of Thoracic Disease(JTD) Editorial Board, I wanted to dedicate a special supplement to review the most controversial issues on such complex neoplasms.
Update in pathological classification of lung and thymic neuroendocrine tumors are reported in the first part of the present supplement, along with the results of surgical treatment of Bronchial Carcinoids, according to the Spanish Society of Pneumonology and Thoracic Surgery’s experience. What’s new in the molecular tumors characteristics is reported in a very interesting review paper derived from a recent American/European clinical collaboration. Surgical and oncological point of view of high grade bronchial and thymic neuroendocrine tumors management represent the following contributions, whilst the last review paper is dedicated to the role of peptide receptor radionuclide therapy in advanced/metastatic tumors.
I am deeply indebted to all the Authors who actively contributed to the realization of this JTD issue, as well as to all the JTD Editorial Board (in particular Anne) and all the AME Publishing Company, that believed in this scientific project and carefully cured it with a meticulous print apparel.