Nationwide multicenter study on the management of pulmonary neuroendocrine (carcinoid) tumors. Issue 1 (January 2018)

• Record Type: Journal Article
• Authors: Sadowski, Samira M; Christ, Emanuel; Bédat, Benoit; Kollár, Attila; Karenovics, Wolfram; Perren, Aurel; Triponez, Frédéric
• Is Part Of: Endocrine connections. Volume 7:Issue 1(2018)
• Page Start: 8
• Page End: 15
• Publication Date: 2018-01
• Subjects: pulmonary carcinoids -- surgery -- survival analysis -- registry; Endocrinology -- Periodicals; 616.4005
• DOI: 10.1530/EC-17-0271
• Languages: English
• ISSNs: 2049-3614

Abstract

Abstract : Background and aim: To analyze the management and outcome of patients with primary typical (TC) and atypical lung carcinoids (AC) in Switzerland. Methods: Retrospective analysis of patients selected from a neuroendocrine tumor (NET) registry. Patients were divided into TC and AC according to pathology reports, and surgical procedures were grouped as wedge/segmentectomy, lobectomy/bilobectomy and pneumectomy. Survival analysis was performed using the Kaplan–Meier method and log-rank test. Results: Over 7 years, 113 pulmonary carcinoids (61.9% females, mean age 59.4 years) were included from 19 hospitals, with pathology data on Ki67 and necrosis incomplete in 16 cases. Eighty-three TC and 14 AC underwent surgical resection with a primary tumor size of median 14.5 (range 1–80) mm and diagnosis was established in 55.8% at surgery. Mean follow-up was 30.2 ± 23.1 months. Lobectomy was performed in 54.2% and wedge resection in 17.7% of cases. Six patients received additional systemic therapy. There was a trend for larger primary lesion size and a significantly higher rate of N2–N3 status in AC. Mean survival tended to be increased in patients with TC compared to AC (86.1 vs 48.4 months, P = 0.06) and mean disease-free interval after surgical resection was 74.1 and 48.3 months for TC and AC, respectively ( P = 0.74). Conclusion: AC of the lung has a more malignant behavior and a trend to a worse outcome. The results of this registry reinforce the need for standardized histological diagnosis and inter-disciplinary therapeutic decision making to improve the quality of care of patients with TC and AC.