Natural History of Localized and Locally Advanced Atypical Lung Carcinoids after Complete Resection: A Joined...

Area of Science:

• Thoracic Surgery
• Oncology
• Pulmonary Medicine

Background:

• Atypical lung carcinoids (AC) have an ill-defined natural history and optimal follow-up strategies.
• Complete resection (R0) is the primary treatment for stage I-III pulmonary AC.

Purpose of the Study:

• To analyze recurrence-free survival (RFS) after complete resection of pulmonary AC.
• To identify prognostic parameters, recurrence locations, and optimal follow-up modalities.

Main Methods:

• Retrospective review of 62 patients with AC treated between 1998-2008.
• Central pathological review and exclusion of specific patient subgroups.
• Analysis of recurrence-free survival and associated prognostic factors.

Main Results:

• 35% of patients experienced recurrence within a median follow-up of 91 months.
• Lymph node involvement, stage, mitotic count, and surgery type were associated with RFS.
• Lymph node involvement was a significant independent predictor of RFS in multivariate analysis.

Conclusions:

• Recurrences after AC resection occur mainly within the first 5 years.
• Lymph node involvement can guide follow-up stratification for R0 patients.
• Current imaging follow-up practices for AC are suboptimal.