Atypical carcinoid tumours of the lung: prognostic factors and patterns of recurrence. Issue 7 (6th March 2014)

• Record Type: Journal Article
• Authors: Cañizares, M A; Matilla, J M; Cueto, A; Algar, J; Muguruza, I; Moreno-Mata, N; Moreno-Balsalobre, R; Guijarro, R; Arrabal, R; Garcia-Fontan, E; Gonzalez-Piñeiro, A; Garcia-Yuste, M
• Other Names: García-Yuste Mariano author non-byline.; Matilla Jose-Maria author non-byline.; Heras Felix author non-byline.; Borrego Henar author non-byline.; Escobar Ignacio author non-byline.; Moya Joan author non-byline.; Lago Juan author non-byline.; Saldaña David author non-byline.; Garrido Pilar author non-byline.; Cerezo Francisco author non-byline.; Algar Javier author non-byline.; Gonzalez-Aragoneses Federico author non-byline.; Simon Carlos author non-byline.; Alvarez Emilio author non-byline.; Cebollero Maria author non-byline.; Rodriguez-Paniagua Jose-Manuel author non-byline.; Guijarro Ricardo author non-byline.; Arnau Antonio author non-byline.; Lopez-Rivero Luis author non-byline.; Quevedo Santiago author non-byline.; Camacho Maria-Carmen author non-byline.; Astudillo Julio author non-byline.; Perez Javier author non-byline.; Molins Laureano author non-byline.; Mier Jose-Manuel author non-byline.; Cueto Antonio author non-byline.; Sanchez-Palencia Abel author non-byline.; Concha Angel author non-byline.; Freixinet Jorge author non-byline.; Rodriguez Pedro author non-byline.; Romero Teresa author non-byline.; Torres Juan author non-byline.; Bermejo Juan author non-byline.; Moreno Nicolas author non-byline.; Blanco Ana author non-byline.; Borro Jose-Maria author non-byline.; de-la-Torre Mercedes author non-byline.; Capdevilla Ana author non-byline.; Moreno Ramon author non-byline.; Serra Mireia author non-byline.; Rami-Porta Ramon author non-byline.; Arrabal Ricardo author non-byline.; Benitez Antonio author non-byline.; Varela Andres author non-byline.; Cordoba Mar author non-byline.; Cañizares Miguel-Angel author non-byline.; Garcia-Fontan Eva author non-byline.; Blanco-Ramos Montserrat author non-byline.; Gonzalez-Piñeiro Ana author non-byline.; Muguruza Ignacio author non-byline.; Zapatero José author non-byline.; Rivas Juan-Jose author non-byline.; Menal Patricia author non-byline.; Galan Genaro author non-byline.; Ansotegui Emilio author non-byline.;
• Is Part Of: Thorax. Volume 69:Issue 7(2014)
• Page Start: 648
• Page End: 653
• Publication Date: 2014-03-06
• Subjects: Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thoraxjnl-2013-204102
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Background: Atypical carcinoids (AC) of the lung are rare intermediate-grade neuroendocrine neoplasms. Prognostic factors for these tumours are undefined. Methods: Our cooperative group retrieved data on 127 patients operated between 1980 and 2009 because of an AC. Several clinical and pathological features were studied. Results: In a univariable analysis, T-status (p=0.005), N-status (p=0.021), preoperative M-status (previously treated) (p=0.04), and distant recurrence developed during the outcome (p<0.001) presented statistically significant differences related to survival of these patients. In a multivariable analysis, only distant recurrence was demonstrated to be an independent risk factor for survival (p<0.001; HR: 13.1). During the monitoring, 25.2% of the patients presented some kind of recurrence. When we studied recurrence factors in a univariable manner, sublobar resections presented significant relationship with locoregional recurrence (p<0.001). In the case of distant recurrence, T and N status presented significant differences. Patients with preoperative M1 status presented higher frequencies of locoregional and distant recurrence (p=0.004 and p<0.001, respectively). In a multivariable analysis, sublobar resection was an independent prognostic factor to predict locoregional recurrence (p=0.002; HR: 18.1). Conclusions: Complete standard surgical resection with radical lymphadenectomy is essential for AC. Sublobar resections are related to locoregional recurrence, so they should be avoided except for carefully selected patients. Nodal status is an important prognostic factor to predict survival and recurrence. Distant recurrence is related to poor outcome.