Nationwide multicenter study on the management of pulmonary neuroendocrine (carcinoid) tumors

Samira Mercedes Sadowski, Emanuel Christ, Benoit Bedat, Attila Kollár, Wolfram Karenovics, Aurel Perren, Frederic Triponez
2018
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
more » ... ars, 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.
doi:10.7892/boris.108058 fatcat:4twk3vuiqzc7hmidrajhv7ud4i