PS02.27 Primary Pulmonary Carcinoid Tumors: A Single Institution Retrospective Review: Topic: Medical Oncology

Abstract

Pulmonary carcinoid tumors account for 1–2% of all invasive lung malignancies. They generally occur between the fourth and the sixth decade of life. Most pulmonary carcinoid tumors are well differentiated, have < 2 mitoses/10 HPF and < 3% Ki67 index (typical carcinoid). A small percentage are aggressive, have 2-20 mitoses/10 HPF and 3-20% Ki67 index (atypical carcinoid). We present a retrospective analysis of the clinico-pathologic features of patients diagnosed with pulmonary carcinoids tumor at the LVHN over a ten year period. Patients with primary pulmonary carcinoid tumors diagnosed between 2005 and 2015 were identified from tumor registry. Records were de-identified and reviewed. Ninety-six patients with primary pulmonary carcinoid were identified. Median age was 63.5 years. 69% were female and 97% were Caucasian. The most common presenting symptoms were cough (22%), dyspnea (17%), chest pain (11%), pneumonia (9%) and hemoptysis (6%). 56% had no symptoms. 86 patients had typical carcinoids and 10 patients had atypical carcinoids. 75% were stage 1, 5% stage II, 4% stage III and 6% stage IV with metastases to bone, lung and liver. 10% had multifocal pulmonary disease. 90% underwent surgery (62% lobectomy, 20% wedge resection, 4% segmental resection, 4% pneumonectomy and 2% endobronchial ablation). Two patients had concurrent lobectomy and wedge resection. Five patients received chemotherapy, 3 with metastatic disease, 1 with stage IIIA and 1 misdiagnosed small cell lung carcinoma. Chemotherapy regimens involved cisplatin and etoposide in 3 patients, and 2 patients received treatment elsewhere. Three patients received radiation therapy. One had prophylactic cranial irradiation, 1 required palliative radiation for painful bony metastases and 1 received concurrent radiation with chemotherapy. Four patients had disease recurrence, 2 of whom died of metastatic pulmonary carcinoid. Ten patients died during the study period from other causes. Primary pulmonary carcinoids are rare tumors more common in females. Common presenting symptoms are cough, dyspnea, chest pain and pneumonia. Surgery is the mainstay of treatment. Chemotherapy and radiation therapy are rarely used except in the metastatic setting. Keeping with the indolent nature of the disease, most patients die of other causes.