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Prognostic Factors in Typical and Atypical Pulmonary Carcinoids.
Robert A Ramirez1,2, David T Beyer3, Anne E Diebold3
1Department of Hematology and Oncology, Ochsner Clinic Foundation, New Orleans, LA.
Ochsner Journal
|December 13, 2017
Summary
Patients with bronchial carcinoids, a type of neuroendocrine tumor (NET), generally have long survival rates. The Ki-67 index, a marker of cell proliferation, showed significant differences in survival for these lung NETs.
Area of Science:
- Pulmonology
- Oncology
- Pathology
Background:
- Bronchopulmonary neuroendocrine tumors (NETs), including typical and atypical carcinoids, comprise about 2% of all lung tumors.
- Survival for typical bronchial carcinoids is generally long but stage-dependent.
- This study presents findings from the Ochsner Medical Center/Louisiana State University Health Sciences Center NET program.
Purpose of the Study:
- To analyze survival rates and prognostic factors in patients with bronchopulmonary carcinoids.
- To evaluate the utility of the Ki-67 index as a prognostic indicator for bronchial carcinoids.
Main Methods:
- A retrospective analysis of patients diagnosed with bronchopulmonary carcinoid tumors treated at Ochsner Medical Center/LSU NET program from January 1996 to March 2015.
- Inclusion criteria required confirmed pathologic bronchopulmonary carcinoid and at least one clinic visit.
- Exclusion criteria included large cell NET, small cell NET, and diffuse idiopathic pulmonary neuroendocrine cell hyperplasia.
Main Results:
- A total of 169 patients met the inclusion criteria, with a mean age at diagnosis of 53 years.
- 5- and 10-year survival rates were 88% and 81% for well-differentiated tumors, and 80% and 42% for moderately differentiated tumors, respectively.
- Significant survival differences were observed based on nodal status, differentiation, and Ki-67 index (P<0.05).
Conclusions:
- Bronchial carcinoids exhibit favorable long-term survival rates.
- Nodal status, tumor differentiation, and Ki-67 index are significant prognostic factors.
- The Ki-67 index may serve as a valuable prognostic indicator for bronchial carcinoids, similar to its role in gastroenteropancreatic NETs.
