Long-term survival and recurrence after resection of bronchopulmonary carcinoids: A single-center cohort study of 236 patients

Patrick Soldath,Tina Binderup,Andreas Kjær,Birgitte Federspiel,Seppo W Langer,Ulrich Knigge,René Horsleben Petersen

doi:10.1016/j.lungcan.2021.04.010

Patrick Soldath, Tina Binderup + Show 5 more

Open Access

https://doi.org/10.1016/j.lungcan.2021.04.010

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Journal: Lung Cancer	Publication Date: Apr 26, 2021
Citations: 15	License type: cc-by

Affiliation: University of Copenhagen, Rigshospitalet

Abstract

ObjectiveThe aim of this study was to determine overall survival and recurrence-free survival after resection of bronchopulmonary carcinoids by means of predominantly minimally invasive surgery and lung-sparing resections. In addition, we aimed to identify prognostic factors for overall survival. Materials and methodsRetrospective review of consecutive patients operated for bronchopulmonary carcinoids between January 2009 and October 2020 identified from a prospectively collected database. ResultsA total of 236 patients representing 240 cases of bronchopulmonary carcinoids were included. Of these, 212 (88.3 %) were typical carcinoids, while 28 (11.7 %) were atypical carcinoids. A Video-Assisted Thoracoscopic Surgery (VATS) approach was used in 75 % of cases. There was no 30-day mortality. The median follow-up was 5.6 years for overall survival and 4.7 years for recurrence-free survival. 5- and 10-year overall survival rates were 89 % and 71 %, while 5- and 10-year recurrence-free survival rates were 84 % and 71 %. Patients with atypical carcinoids had significantly reduced overall survival and recurrence-free survival rates (HR 3.4; 95 % CI 1.5–7.6; p = 0.003 and HR 5.4; 95 % CI 2.6–11.4; p < 0.001). Independent predictors of overall survival included atypical carcinoid (HR 2.7; 95 % CI 1.2–6.0; p = 0.018) and age > 60 years (HR 2.9; 95 % CI 1.2–7.3; p = 0.021). ConclusionSurgery for bronchopulmonary carcinoids by means of predominantly VATS and lung-sparing resections provides favorable long-term survival. Atypical carcinoids and age > 60 years are independent predictors of poor overall survival.

Highlights

Bronchopulmonary carcinoids (BC) are relatively rare primary lung malignancies accounting for 1 %–3 % of primary lung cancers and 25 % of all neuroendocrine neoplasms in the body [1,2]
According to histology criteria revised by Travis and colleagues in 2015 [6], BC are divided into typical (TC) and atypical carcinoids (AC)
A total of 236 patients were included, of which three patients were diagnosed with synchronous TC and one patient with metachronous TC and AC resulting in 240 cases. 212 cases (88.3 %) were TC and 28 (11.7 %) were AC

Summary

Introduction

Bronchopulmonary carcinoids (BC) are relatively rare primary lung malignancies accounting for 1 %–3 % of primary lung cancers and 25 % of all neuroendocrine neoplasms in the body [1,2]. The inci dence of these tumors has been rising significantly over the past three. According to histology criteria revised by Travis and colleagues in 2015 [6], BC are divided into typical (TC) and atypical carcinoids (AC). TC comprise about 90 % of BC and show relatively low malignant behavior with excellent prognosis following complete resection. Surgery remains the mainstay of treatment for patients with BC and choice of resection may vary according to tumor histology and stage [10]

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Conclusion