Operated bronchial carcinoid tumors: impact of lymph node status and histological type on long-term outcomes

Bronchial carcinoid tumors are rare neuroendocrine tumors, their treatment relies on surgical resection with lymph node dissection. Their central location may make surgery more complex. The primary objective of this study is to assess the impact of lymph node status and histological type of carcinoid lesions on long-term outcome. The secondary objective is to analyze factors associated with perioperative outcomes of operated carcinoid tumors.

This is a retrospective, monocentric, uncontrolled study conducted from January 2011 to December 2022. Inclusion criteria were patients who underwent pulmonary resection for bronchial carcinoid tumors at Tenon University Hospital. The primary endpoint of this study is overall and recurrence-free survival. The secondary endpoint was perioperative outcomes.

102 patients were included: 87 typical carcinoids (85.3%) and 15 atypical carcinoids (14.7%). There were 34 men (33.3%) and 68 women (66.7%). Mean age was 53.2 ± 16.8 years. Thirty-five patients (34.3%) presented postoperative complications, including six severe complications (5.9%) defined by a Clavien-Dindo score ≥ IIIA. No factors associated with peri‑operative outcomes were identified in the univariate analysis. Overall survival was 92.5% [86.5-98.9] at 10 years. Node involvement significantly influenced recurrence-free survival (65.9% for patients with node involvement vs. 96.3% for patients without p < 0.01) but had no impact on overall survival (92.3% vs. 95.0% respectively, p = 0.24).

Surgery of bronchial carcinoid tumors is associated with an excellent prognosis. Lymph node involvement appeared to influence recurrence-free survival, but not overall survival, underlining the prognostic importance of lymphadenectomy. Optimizing post-operative management and follow-up of patients with lymph node involvement represents an interesting area of research.