A single-institution retrospective analysis of metachronous and synchronous metastatic bronchial neuroendocrine tumors

Peri, Marta; Botteri, Edoardo; Pisa, Eleonora; Marinis, Filippo de; Ungaro, Antonio; Spada, Francesca; Grana, Chiara Maria; Gasparri, Roberto; Spaggiari, Lorenzo; Romentz, Nicole; Badalamenti, Giuseppe; Russo, Antonio; Fazio, Nicola

doi:10.21037/jtd.2018.06.78

Cited by 16 publications

(34 citation statements)

References 36 publications

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“…Gender, extent of disease, ECOG PS, hemoglobin, LDH, NSE and chemotherapy disease control are well-recognized prognostic factors for SCLC and LCNEC. 14 – 20 …”

Section: Discussionmentioning

confidence: 99%

Analysis of systemic inflammatory biomarkers in neuroendocrine carcinomas of the lung: prognostic and predictive significance of NLR, LDH, ALI, and LIPI score

et al. 2020

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Background: Lung neuroendocrine carcinoma (NEC) is characterized by aggressive clinical behavior and lack of treatment advances. We evaluate the prognostic and the predictive roles of systemic inflammatory biomarkers in patient circulating blood: neutrophil–lymphocyte ratio (NLR), lactate dehydrogenase (LDH), advanced lung cancer inflammation index (ALI), and the Lung Immune Prognostic Index (LIPI) score. Methods: A total of 120 patients with small-cell lung cancer (SCLC) ( n = 110) and large cell neuroendocrine carcinoma (LCNEC) ( n = 10) were enrolled. Overall survival (OS) was evaluated by Kaplan–Meier estimator and univariate and multivariate Cox proportional hazard analyses were performed to determine prognostic factors associated with OS while χ2 test was used for categorical data. Results: NLR cutoff value was 1.93. NLR was measured before and after first-line chemotherapy; 25 (21%) patients had higher NLR (delta NLR >1), whereas NLR was lower in 37 (31%). At the univariate analysis, median OS was 12 months: OS for SCLC and LCNEC were 11 months and 14 months, respectively. OS had a prognostic positive value in patients with pre-treatment NLR <1.93 ( p = 0.0002), LDH <600 U/L ( p = 0,03) and ALI ⩾34 ( p = 0,0065). At the multivariate analysis, Eastern Cooperative Oncology Group performance status, LDH levels and response after first-line chemotherapy were independently associated with OS. Median OS for good, intermediate, and poor LIPI was 15 months, 11 months, and 9 months, respectively( p = 0.091). Patients with higher NLR (>1.93) had an increased probability of tumor progression ( p = 0.045, χ2 test). Conclusion: This study demonstrated that systemic inflammatory biomarkers could facilitate the understanding of survival differences in the clinical management of lung NEC patients, underlying the need for prospective biomarker-driven studies in the immune checkpoint inhibitors setting.

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“…Gender, extent of disease, ECOG PS, hemoglobin, LDH, NSE and chemotherapy disease control are well-recognized prognostic factors for SCLC and LCNEC. 14 – 20 …”

Section: Discussionmentioning

confidence: 99%

Analysis of systemic inflammatory biomarkers in neuroendocrine carcinomas of the lung: prognostic and predictive significance of NLR, LDH, ALI, and LIPI score

et al. 2020

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“…Carcinoid tumors are part of the neuroendocrine tumors APUD (Amine Precursor Uptake and Decarboxylation) originating in the Kulchitsky cells (agent affine cells). Pulmonary carcinoid tumors are part of bronchopulmonary neuroendocrine neoplasms (bpNETs) along with large and small cell pulmonary carcinoma (1). The first resection of this type of tumor was performed by Eloesser (2) through bronchotomy in 1939.…”

Section: Introductionmentioning

confidence: 99%

Neuroendocrine syndrome in bronchial carcinoid tumors

et al. 2020

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Pulmonary carcinoid tumors represent bronchopulmonary neuroendocrine neoplasms which might synthetize serotonin, histamine, bombesin or other types of hormones responsible for the development of a broad spectrum of signs and symptoms, known as carcinoid syndrome. Data of 98 patients submitted to surgery for bronchial carcinoid tumors in the Thoracic Surgery Clinic of the 'Marius Nasta' Institute of Pneumophtisiology between 2014 and 2018 were retrospectively reviewed. All patients were submitted to paraclinical tests, imagistic studies (computed tomography or magnetic resonance imaging), bronchoscopy and biopsy in order to have a positive diagnostic of pulmonary carcinoid. The most common clinical symptoms at the time of presentation were: Persistent cough followed by dyspnea and recurrent pulmonary infections. The main neuroendocrine syndromes found were Cushing and Carcinoid Syndrome. All patients were submitted to surgery with curative intent consisting of wedge resection (in 4 cases, 4.08%), lobectomy (in 79 cases, 80.61%), bilobectomy (in 5 cases, 5.1%) and pneumonectomy respectively (in 10 cases, 10.2%). In all cases neuroendocrine specific symptoms disappeared once the carcinoid tumor was removed. In conclusion, bronchial carcinoid tumors have a positive outcome in most cases. Specific neuroendocrine markers as well as neuroendocrine syndrome disappears once the tumor is removed.

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“…Metastases usually occur in regional lymph nodes but also distantly to the liver, bones, lung, distant lymph node and subcutis. 27 , 32 , 37 …”

Section: The Biological Landscape Of Neuroendocrine Tumor Of the Lungmentioning

confidence: 99%

“…However metastatic survival data are lacking and have been mainly extracted from SEER database analysis 30 , 36 and retrospective analyses. 32 , 38 , 39 …”

Section: The Biological Landscape Of Neuroendocrine Tumor Of the Lungmentioning

confidence: 99%

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<p>Clinical Evaluation of Everolimus in the Treatment of Neuroendocrine Tumors of the Lung: Patient Selection and Special Considerations. A Systematic and Critical Review of the Literature</p>

Peri

Fazio

2020

LCTT

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Neuroendocrine tumors (NETs) of the lung are well-differentiated neuroendocrine neoplasms (NENs) with a heterogeneous clinical behaviour. Unlike gastroenteropancreatic NENs where therapeutic armamentarium clearly increased over the last decade, everolimus represented the only clinical practical innovation for lung NET patients over the last years. Therefore, for lung NETs, a multidisciplinary discussion within a dedicated team remains critical for an adequate decision-making. Although the main regulatory authorities considered the everolimus-related evidence is enough to approve the drug in advanced lung NETs, several clinical features deserve to be discussed. In this review, we systemically and critically analysed the main clinical studies including patients with advanced lung NETs receiving everolimus. Furthermore, we reported the biological and clinical background of everolimus in lung NET setting. The purpose of this review is to help clinical community to contextualize evidence and experience for a personalised use of this drug in clinical practice in the context of advanced lung NET patients.

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A single-institution retrospective analysis of metachronous and synchronous metastatic bronchial neuroendocrine tumors

Cited by 16 publications

References 36 publications

Analysis of systemic inflammatory biomarkers in neuroendocrine carcinomas of the lung: prognostic and predictive significance of NLR, LDH, ALI, and LIPI score

Analysis of systemic inflammatory biomarkers in neuroendocrine carcinomas of the lung: prognostic and predictive significance of NLR, LDH, ALI, and LIPI score

Neuroendocrine syndrome in bronchial carcinoid tumors

<p>Clinical Evaluation of Everolimus in the Treatment of Neuroendocrine Tumors of the Lung: Patient Selection and Special Considerations. A Systematic and Critical Review of the Literature</p>

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