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Erschienen in: General Thoracic and Cardiovascular Surgery 7/2023

27.01.2023 | Original Article

Prognostic factors for pulmonary carcinoid with positive lymph node after surgical resection: a SEER database study

verfasst von: Xiaoling Wang, Tingting Liu, Jun Chen, Jun Dang

Erschienen in: General Thoracic and Cardiovascular Surgery | Ausgabe 7/2023

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Abstract

Background

Prognostic factors and role with chemotherapy (CT) and radiotherapy (RT) remain unclear for patients of pulmonary carcinoid (PC) with positive lymph node after surgery.

Methods

PC patients who underwent surgery and with positive lymph node between 2000 and 2016 were identified from the SEER database. Univariate and multivariate cox regression analysis were used to identify independent risk factors for overall survival (OS).

Results

A total of 552 patients were identified. Multivariate analysis indicated that age (≤ 70/ > 70) (HR = 0.32, 95% CI 0.21–0.50; P < 0.001), histologic type (typical carcinoid [TC]/atypical carcinoid [AC]) (HR = 0.53, 95% CI 0.36–0.78, P = 0.001), number of positive lymph nodes (n ≥ 3/n = 1–2) (HR = 1.91, 95% CI 1.26–2.90; P = 0.002), and treatment mode (surgery + RT/surgery alone) (HR = 1.75, 95% CI 1.09–2.81; P 0.02) were independent prognostic factors for OS. In subgroup analysis according to histological type, prognostic factors were similar between AC and TC, except surgery + RT being negative prognostic factor for TC but AC. No significant difference in OS was observed between the surgery alone and surgery + CT in any subgroup of patients.

Conclusions

Age > 70, histological type of AC, positive lymph nodes ≥ 3, and surgery + RT were likely to be negative prognostic factors for OS. Addition CT to surgery did not appear to provide additional OS benefit.
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Literatur
1.
Zurück zum Zitat Caplin ME, Baudin E, Ferolla P, et al. Pulmonary neuroendocrine (carcinoid) tumors: European Neuroendocrine Tumor Society expert consensus and recommendations for best practice for typical and atypical pulmonary carcinoids. Ann Oncol. 2015;26(8):1604–20.CrossRefPubMed Caplin ME, Baudin E, Ferolla P, et al. Pulmonary neuroendocrine (carcinoid) tumors: European Neuroendocrine Tumor Society expert consensus and recommendations for best practice for typical and atypical pulmonary carcinoids. Ann Oncol. 2015;26(8):1604–20.CrossRefPubMed
2.
Zurück zum Zitat Bertino EM, Confer PD, Colonna JE, Ross P, Otterson GA. Pulmonary neuroendocrine/carcinoid tumors: a review article. Cancer. 2009;115(19):4434–41.CrossRefPubMed Bertino EM, Confer PD, Colonna JE, Ross P, Otterson GA. Pulmonary neuroendocrine/carcinoid tumors: a review article. Cancer. 2009;115(19):4434–41.CrossRefPubMed
3.
Zurück zum Zitat Hilal T. Current understanding and approach to well differentiated lung neuroendocrine tumors: an update on classification and management. Ther Adv Med Oncol. 2017;9(3):189–99.CrossRefPubMed Hilal T. Current understanding and approach to well differentiated lung neuroendocrine tumors: an update on classification and management. Ther Adv Med Oncol. 2017;9(3):189–99.CrossRefPubMed
4.
Zurück zum Zitat Lim E, Yap YK, De Stavola BL, Nicholson AG, Goldstraw P. The impact of stage and cell type on the prognosis of pulmonary neuroendocrine tumors. J Thorac Cardiovasc Surg. 2005;130(4):969–72.CrossRefPubMed Lim E, Yap YK, De Stavola BL, Nicholson AG, Goldstraw P. The impact of stage and cell type on the prognosis of pulmonary neuroendocrine tumors. J Thorac Cardiovasc Surg. 2005;130(4):969–72.CrossRefPubMed
5.
Zurück zum Zitat Nussbaum DP, Speicher PJ, Gulack BC, et al. Defining the role of adjuvant chemotherapy after lobectomy for typical bronchopulmonary carcinoid tumors. Ann Thorac Surg. 2015;99(2):428–34.CrossRefPubMed Nussbaum DP, Speicher PJ, Gulack BC, et al. Defining the role of adjuvant chemotherapy after lobectomy for typical bronchopulmonary carcinoid tumors. Ann Thorac Surg. 2015;99(2):428–34.CrossRefPubMed
6.
Zurück zum Zitat Kaifi JT, Kayser G, Ruf J, Passlick B. The diagnosis and treatment of bronchopulmonary carcinoid. Dtsch Arztebl Int. 2015;112(27–28):479–85.PubMedPubMedCentral Kaifi JT, Kayser G, Ruf J, Passlick B. The diagnosis and treatment of bronchopulmonary carcinoid. Dtsch Arztebl Int. 2015;112(27–28):479–85.PubMedPubMedCentral
7.
Zurück zum Zitat Daddi N, Schiavon M, Filosso PL, et al. Prognostic factors in a multicentre study of 247 atypical pulmonary carcinoids. Eur J Cardiothorac Surg. 2014;45(4):677–86.CrossRefPubMed Daddi N, Schiavon M, Filosso PL, et al. Prognostic factors in a multicentre study of 247 atypical pulmonary carcinoids. Eur J Cardiothorac Surg. 2014;45(4):677–86.CrossRefPubMed
8.
Zurück zum Zitat Anderson KL Jr, Mulvihill MS, Speicher PJ, et al. Adjuvant chemotherapy does not confer superior survival in patients with atypical carcinoid tumors. Ann Thorac Surg. 2017;104(4):1221–30.CrossRefPubMedPubMedCentral Anderson KL Jr, Mulvihill MS, Speicher PJ, et al. Adjuvant chemotherapy does not confer superior survival in patients with atypical carcinoid tumors. Ann Thorac Surg. 2017;104(4):1221–30.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Wegner RE, Abel S, Hasan S, et al. The role of adjuvant therapy for atypical bronchopulmonary carcinoids. Lung Cancer. 2019;131:90–4.CrossRefPubMed Wegner RE, Abel S, Hasan S, et al. The role of adjuvant therapy for atypical bronchopulmonary carcinoids. Lung Cancer. 2019;131:90–4.CrossRefPubMed
10.
Zurück zum Zitat Walters SL, Canavan ME, Salazar MC, et al. A national study of surgically managed atypical pulmonary carcinoid tumors. Ann Thorac Surg. 2021;112(3):921–7.CrossRefPubMed Walters SL, Canavan ME, Salazar MC, et al. A national study of surgically managed atypical pulmonary carcinoid tumors. Ann Thorac Surg. 2021;112(3):921–7.CrossRefPubMed
11.
Zurück zum Zitat Rea F, Rizzardi G, Zuin A, et al. Outcome and surgical strategy in bronchial carcinoid tumors: single institution experience with 252 patients. Eur J Cardiothorac Surg. 2007;31(2):186–91.CrossRefPubMed Rea F, Rizzardi G, Zuin A, et al. Outcome and surgical strategy in bronchial carcinoid tumors: single institution experience with 252 patients. Eur J Cardiothorac Surg. 2007;31(2):186–91.CrossRefPubMed
12.
Zurück zum Zitat Cardillo G, Sera F, Di Martino M, et al. Bronchial carcinoid tumors: nodal status and long-term survival after resection. Ann Thorac Surg. 2004;77(5):1781–5.CrossRefPubMed Cardillo G, Sera F, Di Martino M, et al. Bronchial carcinoid tumors: nodal status and long-term survival after resection. Ann Thorac Surg. 2004;77(5):1781–5.CrossRefPubMed
13.
Zurück zum Zitat Wolin EM. Advances in the diagnosis and management of well-differentiated and intermediate-differentiated neuroendocrine tumors of the lung. Chest. 2017;151(5):1141–6.CrossRefPubMed Wolin EM. Advances in the diagnosis and management of well-differentiated and intermediate-differentiated neuroendocrine tumors of the lung. Chest. 2017;151(5):1141–6.CrossRefPubMed
14.
Zurück zum Zitat García-Yuste M, Matilla JM, Cueto A, et al. Typical and atypical carcinoid tumours: analysis of the experience of the Spanish multi-centric study of neuroendocrine tumours of the lung. Eur J Cardiothorac Surg. 2007;31(2):192–7.CrossRefPubMed García-Yuste M, Matilla JM, Cueto A, et al. Typical and atypical carcinoid tumours: analysis of the experience of the Spanish multi-centric study of neuroendocrine tumours of the lung. Eur J Cardiothorac Surg. 2007;31(2):192–7.CrossRefPubMed
15.
Zurück zum Zitat Thakur S, Florisson D, Telianidis S, et al. Pulmonary carcinoid tumours: a multi-centre analysis of survival and predictors of outcome following sublobar, lobar, and extended pulmonary resections. Asian Cardiovasc Thorac Ann. 2021;29(6):532–40.CrossRefPubMed Thakur S, Florisson D, Telianidis S, et al. Pulmonary carcinoid tumours: a multi-centre analysis of survival and predictors of outcome following sublobar, lobar, and extended pulmonary resections. Asian Cardiovasc Thorac Ann. 2021;29(6):532–40.CrossRefPubMed
16.
Zurück zum Zitat Gustafsson BI, Kidd M, Chan A, Malfertheiner MV, Modlin IM. Bronchopulmonary neuroendocrine tumors. Cancer. 2008;113(1):5–21.CrossRefPubMed Gustafsson BI, Kidd M, Chan A, Malfertheiner MV, Modlin IM. Bronchopulmonary neuroendocrine tumors. Cancer. 2008;113(1):5–21.CrossRefPubMed
17.
Zurück zum Zitat Cañizares MA, Matilla JM, Cueto A, et al. Atypical carcinoid tumours of the lung: prognostic factors and patterns of recurrence. Thorax. 2014;69(7):648–53.CrossRefPubMed Cañizares MA, Matilla JM, Cueto A, et al. Atypical carcinoid tumours of the lung: prognostic factors and patterns of recurrence. Thorax. 2014;69(7):648–53.CrossRefPubMed
18.
Zurück zum Zitat Huang Y, Yang X, Lu T, et al. Assessment of the prognostic factors in patients with pulmonary carcinoid tumor: a population-based study. Cancer Med. 2018;7(6):2434–41.CrossRefPubMedPubMedCentral Huang Y, Yang X, Lu T, et al. Assessment of the prognostic factors in patients with pulmonary carcinoid tumor: a population-based study. Cancer Med. 2018;7(6):2434–41.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Prinzi N, Rossi RE, Proto C, et al. Recent advances in the management of typical and atypical lung carcinoids. Clin Lung Cancer. 2021;22(3):161–9.CrossRefPubMed Prinzi N, Rossi RE, Proto C, et al. Recent advances in the management of typical and atypical lung carcinoids. Clin Lung Cancer. 2021;22(3):161–9.CrossRefPubMed
20.
Zurück zum Zitat Okoye CC, Jablons DM, Jahan TM, Kukreja J, Cardozo S, Yom SS. Divergent management strategies for typical versus atypical carcinoid tumors of the thoracic cavity. Am J Clin Oncol. 2014;37(4):350–5.CrossRefPubMed Okoye CC, Jablons DM, Jahan TM, Kukreja J, Cardozo S, Yom SS. Divergent management strategies for typical versus atypical carcinoid tumors of the thoracic cavity. Am J Clin Oncol. 2014;37(4):350–5.CrossRefPubMed
21.
Zurück zum Zitat Fox M, Van Berkel V, Bousamra M 2nd, Sloan S, Martin RC 2nd. Surgical management of pulmonary carcinoid tumors: sublobar resection versus lobectomy. Am J Surg. 2013;205(2):200–8.CrossRefPubMed Fox M, Van Berkel V, Bousamra M 2nd, Sloan S, Martin RC 2nd. Surgical management of pulmonary carcinoid tumors: sublobar resection versus lobectomy. Am J Surg. 2013;205(2):200–8.CrossRefPubMed
22.
Zurück zum Zitat Steuer CE, Behera M, Kim S, et al. Atypical carcinoid tumor of the lung: a surveillance, epidemiology, and end results database analysis. J Thorac Oncol. 2015;10(3):479–85.CrossRefPubMed Steuer CE, Behera M, Kim S, et al. Atypical carcinoid tumor of the lung: a surveillance, epidemiology, and end results database analysis. J Thorac Oncol. 2015;10(3):479–85.CrossRefPubMed
Metadaten
Titel
Prognostic factors for pulmonary carcinoid with positive lymph node after surgical resection: a SEER database study
verfasst von
Xiaoling Wang
Tingting Liu
Jun Chen
Jun Dang
Publikationsdatum
27.01.2023
Verlag
Springer Nature Singapore
Erschienen in
General Thoracic and Cardiovascular Surgery / Ausgabe 7/2023
Print ISSN: 1863-6705
Elektronische ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-023-01910-1

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