Prognostic nomogram and epidemiological analysis for lung atypical carcinoid: A SEER database and external validation...

Area of Science:

• Pulmonary oncology
• Epidemiology
• Surgical oncology

Background:

• Pulmonary carcinoids, including atypical carcinoid (AC) and typical carcinoid (TC), represent a significant group of lung neuroendocrine tumors.
• Understanding their epidemiological distribution and prognostic factors is crucial for effective patient management.

Purpose of the Study:

• To delineate the epidemiology of pulmonary carcinoids (AC and TC).
• To identify independent prognostic factors for atypical carcinoid (AC).
• To develop a nomogram for AC prognosis and evaluate surgical modalities' impact on AC-specific survival (ACSS).

Main Methods:

• Joinpoint regression and age-group distribution for epidemiological trends.
• Univariate and LASSO-Cox regression for prognostic factor identification.
• Nomogram and web-based predictor development for AC prognosis.
• Kaplan-Meier analysis and G-computation for surgical outcomes.

Main Results:

• 1132 patients analyzed; AC patients averaged 63.4 years, with 79.8% having a smoking history.
• Rising annual incidence rates of AC and carcinoid tumors observed.
• Nomogram demonstrated excellent accuracy in predicting 1, 3, and 5-year AC survival.
• Sublobar resection showed non-inferior survival outcomes compared to lobectomy for early-to-advanced stage disease.

Conclusions:

• First study to detail pulmonary carcinoid epidemiological trends over a decade and across age groups.
• Sublobar resection may be a suitable surgical option for early-stage AC.
• Developed nomogram and calculator offer practical prognostic tools.