P2.12-25 Surgical Management of Pulmonary Carcinoid ≤3cm: Extent of Resection and Lymph Nodes Examination

Abstract

Early stage lung cancer is being detected at a higher frequency with the development of advanced screening programs. We aimed to investigate the optimal surgical approach in pulmonary carcinoid ≤3cm. Patients with microscopically confirmed pulmonary carcinoid tumors ≤3cm were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2015. Cancer specific survival (CSS), defined as the survival time from cancer diagnosis to death specific to cancer-related death, was the primary outcome variable. Survival curves were plotted with Kaplan-Meier analysis and the difference in survival was estimated by log-rank tests. Multivariate Cox regression methods determined the independent prognostic factors after adjusting for other confounding factors. A total of 2986 patients were included in this study, which comprised 2785 typical carcinoids (TC) and 201 atypical carcinoids (AC). AC histology was associated with larger tumor size and increased risk of nodal metastasis. Lobectomy was performed for bigger carcinoid and correlated with more resected lymph nodes. Sublobectomy was noninferior to lobectomy with regards to CSS. Although lymph nodes involvement conferred significantly decreased survival, lymph nodes resection did not improve survival in either typical or atypical carcinoids. For patients with T1-sized pulmonary carcinoids, sublobar resection results in similar survival rate compared with lobectomy. Lymph nodes examination did not independently predict survival.