Outcome and Prognostic Factors in Bronchial Carcinoids: A Single-Center Experience

Filosso, Pier Luigi; Oliaro, A; Ruffini, Enrico; Bora, Giulia; Lybéris, Paraskevas; Asioli, Sofia; Delsedime, Luisa; Sandri, Alberto; Guerrera, Francesco

doi:10.1097/jto.0b013e31829f097a

Cited by 69 publications

(65 citation statements)

References 35 publications

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“…TCs metastasize in about 20% of cases 6,35 and the rates of metastasis at diagnosis in our patients with TC was similar at 23.68%. Metastasis was identified in 31.81% of the patients with AC.…”

Section: Discussionsupporting

confidence: 64%

Well‐differentiated bronchial neuroendocrine tumors: Clinical management and outcomes in 105 patients

Pericleous

Karpathakis

Toumpanakis

et al. 2017

Clinical Respiratory J

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Section: Discussionsupporting

confidence: 64%

Well‐differentiated bronchial neuroendocrine tumors: Clinical management and outcomes in 105 patients

Pericleous

Karpathakis

Toumpanakis

et al. 2017

Clinical Respiratory J

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“…All of the patients who received adjuvant therapy in this study underwent complete resection Due to the lack of prospective randomized clinical trials, the role of adjuvant therapy in node-negative atypical carcinoid is undefined. However, the benefits of adjuvant chemotherapy have been analyzed in small retrospective cohort series [1, 9, 21–23]. In a single institutional study by Perkins et al, in a study of 73 patients with both typical and atypical lung carcinoids, seven of whom received adjuvant chemotherapy and/or radiation therapy due to margin status, lymph node status, or invasion into surrounding structures.…”

Section: Commentmentioning

confidence: 99%

“…This therapeutic regimen is based on data that demonstrated a 20% response rate to any chemotherapy [2]. While patients with pulmonary carcinoid tumors have been included in institutional and large-scale studies, very little data exist on the role of adjuvant chemotherapy in node negative atypical carcinoid tumors [9–11]. Studies on the use of adjuvant therapy in pathologic node-positive disease (pN+) are similarly lacking [12].…”

mentioning

confidence: 99%

Adjuvant Chemotherapy Does Not Confer Superior Survival in Patients With Atypical Carcinoid Tumors

Anderson

Mulvihill

Speicher

et al. 2017

The Annals of Thoracic Surgery

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Background Though the use of adjuvant chemotherapy in patients with pathologically node-positive (pN+) atypical carcinoid tumor of the lung is an accepted practice, controversy exists regarding its utilization in node-negative (pN0) patients. Our aim was to determine if a survival advantage exists in patients receiving chemotherapy post-operatively for pN0 or pN+ atypical carcinoid tumors of the lung. Methods Adult patients treated with lobectomy or pneumonectomy for pulmonary atypical carcinoid tumor were identified using the National Cancer Data Base (NCDB), 2006–2011. Propensity scoring (4:1 nearest neighbor algorithm) and survival analysis were employed to examine the association between adjuvant chemotherapy and pathologically node positive (pN+) vs. pathologically node negative (pN0) atypical carcinoid tumors. Results Of the total 581 patients identified with a diagnosis of atypical carcinoid of the lung, 363 (62.5%) were found to be node negative at the time of surgery and 218 (37.5%) had node positive disease. Adjuvant chemotherapy was used in 15 (4.1%) patients with pN0 disease and 89 (40.8%) with pN+. Unadjusted survival, at 12-months and 60-months, was similar between pN+ patients who were treated with adjuvant chemotherapy vs. those who received surgery alone (Adjuvant chemotherapy: 12mo–98.9% 60 mo–47.9% vs. Surgery alone: 12mo–98.4%, 60mo–67.1%, p=0.46) as well as for propensity-matched pN0 (Adjuvant chemotherapy: 12mo–86.7%, 60mo–73.3% vs. Surgery alone: 12mo–87.9%, 60mo–72.3% p=0.54). Conclusions In a national-level analysis, the use of adjuvant chemotherapy post-operatively in patients with pN+ and pN0 disease conferred no survival advantage; further study is needed to determine proper chemotherapy utilization for these patients.

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“…Studies related to surgical treatment were predominantly retrospective cohort studies [3,13, and performed in Europe [3,13,[17][18][19][21][22][23][24][25][26][27][28][29]31,36,38,[40][41][42][43][44][45][46][47][48][49][50]. Both anatomical pulmonary resections (lobectomy, bilobectomy and pneumonectomy) and parenchyma sparing surgical techniques (segmentectomy, sleeve lobectomy, bronchial sleeve, wedge or enucleation of the tumor) were described.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Endobronchial and surgical treatment of pulmonary carcinoid tumors: A systematic literature review

et al. 2019

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A B S T R A C TThe treatment of pulmonary carcinoid has changed over the last decades. Although surgical resection is still the gold standard, minimally invasive endobronchial procedures have emerged as a parenchyma sparing alternative for tumors located in the central airways. This review was performed to identify the optimal treatment strategy for pulmonary carcinoid, with a particular focus on the feasibility and outcome of parenchyma sparing techniques versus surgical resection. A systematic review of the literature was carried out using MEDLINE, Embase and the Cochrane databases, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. Two separate searches of publications in endobronchial and surgical treatment in patients with pulmonary carcinoid, were performed. Outcomes were overall survival, disease free survival, recurrence rate, complications, quality of life, and healthcare costs. Combining the two main searches for endobronchial therapy and surgical therapy yielded 3111 records. Finally, 43 studies concerning surgical treatment and 9 studies related to endobronchial treatment for pulmonary carcinoid were included. Assessment of included studies showed that lymph node involvement, histological grade, tumor location and tumor diameter were identified as poor prognostic factors and seem to be important for patients with pulmonary carcinoid. For patients with a more favorable prognosis, tumor location and tumor diameter are important factors that can help decide on the optimal treatment strategy. Centrally located small intraluminal pulmonary carcinoids, without signs of metastasis can be treated with minimally invasive alternatives such as endobronchial treatment or parenchyma sparing surgical resection. Patients with parenchyma sparing resections should be followed with long term follow up to exclude recurrence of disease. In a multidisciplinary setting, it should be determined whether individual patients are eligible for parenchyma sparing procedures or anatomical resection. Overall evidence is of low quality and future studies should focus on prospective trials in the treatment of pulmonary carcinoid.

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Outcome and Prognostic Factors in Bronchial Carcinoids: A Single-Center Experience

Abstract: Even if characterized by an indolent behavior, BCs may spread to lymph node or distant or present with local recurrence. Amid all prognostic factors, the presence of DM demonstrated to be the strongest negative one.

Cited by 69 publications

References 35 publications

Well‐differentiated bronchial neuroendocrine tumors: Clinical management and outcomes in 105 patients

Well‐differentiated bronchial neuroendocrine tumors: Clinical management and outcomes in 105 patients

Adjuvant Chemotherapy Does Not Confer Superior Survival in Patients With Atypical Carcinoid Tumors

Endobronchial and surgical treatment of pulmonary carcinoid tumors: A systematic literature review

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