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Analysis on the Characteristics and Prognosis of Pulmonary Neuroendocrine Tumors

  • Wu, Bai-Shou (First Department of Medical Oncology, Chinese PLA General Hospital) ;
  • Hu, Yi (First Department of Medical Oncology, Chinese PLA General Hospital) ;
  • Sun, Jing (First Department of Medical Oncology, Chinese PLA General Hospital) ;
  • Wang, Jin-Liang (First Department of Medical Oncology, Chinese PLA General Hospital) ;
  • Wang, Peng (First Department of Medical Oncology, Chinese PLA General Hospital) ;
  • Dong, Wei-Wei (First Department of Medical Oncology, Chinese PLA General Hospital) ;
  • Tao, Hai-Tao (First Department of Medical Oncology, Chinese PLA General Hospital) ;
  • Gao, Wen-Juan (First Department of Medical Oncology, Chinese PLA General Hospital)
  • Published : 2014.03.01

Abstract

Objective: To retrospectively review the clinical characteristics and analyze the prognostic factors of Chinese patients with pulmonary neuroendocrine tumors. Materials and Methods: The clinical data of 176 patients with pulmonary neuroendocrine tumors in Chinese PLA General Hospital from Mar., 2000 to Oct., 2012 were retrospectively analyzed. The parameters were evaluated by univariate and multivariate analysis, including the gender, age, smoking history, family history, TNM staging, localization (central or peripheral), tumor size, nodal status, histological subtype and treatment (operation or non-operation). Results: There were 23 patients with typical carcinoids (TC) (13.1%), 41 with atypical carcinoids (AC) (23.3%), 10 with large cell neuroendocrine carcinoma (LCNEC) (5.7%) and 102 with small cell lung cancer (SCLC) (57.9%). The median follow-up time was 64.5 months for AC, 38 months for LCNEC and 27 months for SCLC. The typical carcinoid censored data was 18 (more than 50% of the patients), so the median follow-up time was not obtained, and actuarial 5-year survivals for TC, AC, LCNEC and SCLC were 75.1%, 51.7%, 26.7% and 38.8%, respectively. COX univariate analysis revealed that the age (P=0.001), histological subtype (P=0.005), nodal status (P=0.000), treatment (P=0.000) and TNM staging (P=0.000) were the prognostic factors of the patients with pulmonary neuroendocrine tumors, whereas its multivariate analysis showed that only the age(P=0.001), TNM staging (P=0.002) and treatment (P=0.000) were independent prognostic factors. Conclusions: Radical surgery remains the treatment of choice, and is the only curative option. The age, TNM staging and treatment are confirmed to be the independent prognostic factors in multivariable models for pulmonary neuroendocrine tumors.

References

  1. Thomas CF Jr, Tazelaar HD, Jett JR (2001). Typical and atypical pulmonary carcinoids: outcome in patients presenting with regional lymph node involvement. Chest, 119, 1143-50. https://doi.org/10.1378/chest.119.4.1143
  2. Yucel B, Babacan NA, Kacan T, et al (2013). Survival analysis and prognostic factors for neuroendocrine tumors in Turkey. Asian Pac J Cancer Prev, 14, 6687-92. https://doi.org/10.7314/APJCP.2013.14.11.6687
  3. Zahir ST, Arjmand A, Kargar S, et al (2013). Incidence and trends of malignant and benign pancreatic lesions in Yazd, Iran between 2001 and 2011. Asian Pac J Cancer Prev, 14, 2631-5. https://doi.org/10.7314/APJCP.2013.14.4.2631
  4. Zeng YJ, Liu L, Wu H, et al (2013). Clinicopathological features and prognosis of gastroenteropancreatic neuroendocrine tumors: analysis from a single-institution. Asian Pac J Cancer Prev, 14, 5775-81. https://doi.org/10.7314/APJCP.2013.14.10.5775
  5. Naalsund A, Rostad H, Strom EH, et al (2011). Carcinoid lung tumors-incidence, treatment and outcomes: a populationbased study. Eur J Cardiothorac Surg, 39, 565-9. https://doi.org/10.1016/j.ejcts.2010.08.036
  6. Rekhtman N (2010). Neuroendocrine tumors of the lung: an update. Arch Pathol Lab Med, 134, 1628-38.
  7. Travis WD (2010). Advances in neuroendocrine lung tumors. Ann Oncol, 21, 65-71. https://doi.org/10.1093/annonc/mdq167
  8. Travis WD, Brambilla E, Muller-Hermelink HK, et al (2004). Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart. Lyon, France: I-ARC Press: World Health Organization Classification of Tumours, 10.
  9. Travis WD, Giroux DJ, Chansky K, et al (2008). The IASLC Lung Cancer Staging Project: Proposals for the inclusion of broncho-pulmonary carcinoid tumors in the forthcoming (seventh) edition of the TNM Classification for Lung Cancer. J Thorac Oncol, 3, 1213-23. https://doi.org/10.1097/JTO.0b013e31818b06e3
  10. Travis WD, Rush W, Flieder DB, et al (1998). Survival analysis of 200 pulmonary neuroendocrine tumors with clarification of criteria for atypical carcinoid and its separation from typical carcinoid. Am J Surg Pathol, 22, 934-44. https://doi.org/10.1097/00000478-199808000-00003
  11. Vallieres E, Shepherd FA, Crowley J, et al (2009). The IASLC Lung Cancer Staging Project: Proposals regarding the relevance of TNM in the pathologic staging of SCLC in the forthcoming (seventh) edition if the TNM classification for lung cancer. J Thorac Oncol, 4, 1049-59. https://doi.org/10.1097/JTO.0b013e3181b27799
  12. Yeh YC, Chou TY (2014). Pulmonary neuroendocrine tumors: study of 90 cases focusing on clinicopathological characteristics, immunophenotype, preoperative biopsy, and frozen section diagnoses. J Surg Oncol, 109, 280-6. https://doi.org/10.1002/jso.23497
  13. Lim E, Yap YK, De Stavola BL, et al (2005). The impact of stage and cell type on the prognosis of pulmonary neuroendocrine tumors. J Thorac Cardiovasc Surg, 130, 969-72. https://doi.org/10.1016/j.jtcvs.2005.05.041
  14. Garcia-Yuste M, Matilla JM, Alvarez-Gago T, et al (2000). Prognostic factors in neuroendocrine lung tumors: a Spanish Multicenter Study. Spanish Multicenter Study of Neuroendocrine Tumors of the Lung of the Spanish Society of Pneumonology and Thoracic Surgery (EMETNESEPAR). Ann Thorac Surg, 70, 258-63. https://doi.org/10.1016/S0003-4975(00)01369-2
  15. Gridelli C1, Rossi A, Airoma G, et al (2013). Treatment of pulmonary neuroendocrine tumours: state of the art and future developments. Cancer Treat Rev, 39, 466-72. https://doi.org/10.1016/j.ctrv.2012.06.012
  16. Haghighi S, Molaei M, Foroughi F, et al (2012). Role of endoscopic ultrasound in evaluation of pancreatic neuroendocrine tumors--report of 22 cases from a tertiary center in Iran. Asian Pac J Cancer Prev, 13, 4537-40. https://doi.org/10.7314/APJCP.2012.13.9.4537
  17. Liu SZ, Zhang F, Chang YX, et al (2013). Prognostic impact of cyclin D1, cyclin E and P53 on gastroenteropancreatic neuroendocrine tumours. Asian Pac J Cancer Prev, 14, 419-22. https://doi.org/10.7314/APJCP.2013.14.1.419
  18. Lyoda A, Hiroshima K, Nakatani Y, et al (2007). Pulmonary LCNEC: its place in the spectrum of pulmonary carcinoma. Ann Thorac Surg, 84, 702-7. https://doi.org/10.1016/j.athoracsur.2007.03.093
  19. Massard G, Ducrocq X, Kochetkova EA, et al (2006). Sampling or node dissection for intraoperative staging of lung cancer: a multicentric cross-sectional study. Eur J Cardiothorac Surg, 30, 164-7. https://doi.org/10.1016/j.ejcts.2006.04.010
  20. McCaughan BC, Martini N, Bains MS (1985). Bronchial carcinoids: review of 124 cases. J Thorac Cardiovasc Surg, 89, 8-17.
  21. Merrill RM, Henson DE, Barnes M (1999). Conditional survival among patients with carcinoma of the lung. Chest, 116, 697-703. https://doi.org/10.1378/chest.116.3.697
  22. Costes V, Marty-Ane C, Picot MC, et al (1995). Typical and atypical bronchopulmonary carcinoid tumors: a clinicopathologic and KI-67-labeling study. Hum Pathol, 26, 740-5. https://doi.org/10.1016/0046-8177(95)90221-X
  23. Cardillo G, Sera F, Di Martino M, et al (2004). Bronchial carcinoid tumors: nodal status and long-term survival after resection. Ann Thorac surg, 77, 1781-5. https://doi.org/10.1016/j.athoracsur.2003.10.089
  24. Carretta A, Ceresoli GL, Arrigoni G, et al (2000). Diagnostic and therapeutic management of neuroendocrine lung tumors: a clinical study of 44 cases. Lung Cancer, 29, 217-25.
  25. Chong S, Lee KS, Chung MJ, et al (2006). Neuroendocrine tumors of the lung: clinical, pathologic, and imaging findings. Radio Graphics, 134, 41-57.
  26. Detterbeck FC (2010). Management of carcinoid tumors. Ann Thorac Surg, 89, 998-1005. https://doi.org/10.1016/j.athoracsur.2009.07.097
  27. Edge SB, Byrd DR, Compton CC, et al (2010). AJCC Cancer Staging Manual. NEW York: Springer.
  28. Ferguson MK, Landreneau RJ, Hazelrigg SR, et al (2000). Longterm outcome after resection for bronchial carcinoid tumors. Eur J Cardiothorac Surg, 18, 156-61. https://doi.org/10.1016/S1010-7940(00)00493-0
  29. Ferolla P, Daddi N, Urbani M, et al (2009). Tumorlets, multicentric carcinoids, lymph-nodal metastases, and long-term behavior in bronchialcarcinoids. Thorac Oncol, 4, 383-7. https://doi.org/10.1097/JTO.0b013e318197f2e7
  30. Fink G, Krelbaum T, Yellin A, et al (2001). Pulmonary carcinoid: presentation, diagnosis, and outcome in 142 cases in Israel and review if 640 cases from literature. Chest, 119, 1647-51. https://doi.org/10.1378/chest.119.6.1647
  31. Filosso PL, Rena O, Donati G, et al (2002). Bronchial carcinoid tumors: surgical management and long-term outcome. J Thorac Cardiovasc Surg, 123, 303-9. https://doi.org/10.1067/mtc.2002.119886
  32. Filosso PL, Ruffini E, Di Gangi S, et al (2014). Prognostic factors in neuroendocrine tumours of the lung: a single-centre experience. Eur J Cardiothorac Surg, 45, 521-6. https://doi.org/10.1093/ejcts/ezt442
  33. Asamura H, Kameya T, Matsuno Y, et al (2006). Neuroendocrine neoplasms of the lung: a prognostic spectrum. J Clin Oncol, 24, 70-6. https://doi.org/10.1200/JCO.2005.04.1202
  34. Beasley MB, Thunnissen FB, Brambilla E, et al (2000). Pulmonary atypical carcinoid: predictors of survival in 106 cases. Hum Pathol, 31, 1255-65. https://doi.org/10.1053/hupa.2000.19294
  35. Bertino EM, Confer PD, Colonna JE, et al (2009). Pulmonary neuroendocrine/carcinoid tumors: a review article. Cancer, 115, 4434-41. https://doi.org/10.1002/cncr.24498

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