The Post-Surgical Long-Term Behaviour of Lung Carcinoid Tumours

Abstract

Here, we report a retrospective evaluation of long-term behaviour of lung carcinoids after surgery. A total of 23 patients (17 with typical pulmonary carcinoids and 6 with atypical pulmonary carcinoids) were enrolled in our hospital from April 1994 to July 2009. All patients underwent intervention at the Unit of Surgery and then were followed at the Unit of Oncology. The standard protocol for patient monitoring consisted of follow-up at 3 months after surgery, 6 months after first control and annually for 5 years. The follow-up evaluations consisted in blood tests, imaging of chest and abdomen, bone scintigraphy, and brain computed tomography. In case of disease recurrence, patients underwent chemotherapy (etoposide, carboplatin) and radiotherapy. All patients were followed for a mean of follow-up period of 100 months, ranging between 20 and 203 months. In the group of typical carcinoid, the observed recurrence rate at 5 years was zero, at 10 years was 5.8 %, whereas the observed mortality rate at 5 and 10 years was zero. In the group of atypical carcinoid, both the recurrence rate and the mortality rate at 5 and 10 years were 16.6 %. A statistical significant difference (p = 0.002) in the recurrence rate between stage I and stage II was observed. The overall prognosis of pulmonary carcinoids was favourable, and the typical carcinoids presented a better prognosis than the atypical ones. The stage at time of diagnosis could be considered as a predictive prognostic factor.

Keywords: Carcinoid tumours; Long term follow-up; Lung cancer; Lymph node metastasis; Tumour behaviour.

Fig. 1

The Kaplan-Meier curve for the overall survival analysis. Hash marks represent the two patients lost from the study (they died because of a different cause from the carcinoid progression)

Fig. 2

The Kaplan-Meier curves show the different survival between the two groups of typical and atypical carcinoids. Hash marks represent the two patients lost from the study (they died because of a different cause from the carcinoid progression)

Fig. 3

The Kaplan-Meier curve for disease recurrence, showing the disease recurrence in typical vs atypical lung carcinoid tumours. The analysis shows a more delayed in the first carcinoid group than in the second one and the recurrence probability in the atypical carcinoid group (16.6 % at 5 years) greater than in the typical one (5.8 % at 10 years). Hash marks represent the two patients lost from the study (they died because of a different cause from the carcinoid progression)