169P - Pulmonary carcinoid tumors: Experience from an oncology center

Date 07 May 2017
Event ELCC 2017
Session Poster Display Session
Topics Mesothelioma
Thoracic malignancies
Presenter Li Bei
Citation Annals of Oncology (2017) 28 (suppl_2): ii56-ii58. 10.1093/annonc/mdx093
Authors L. Bei1, A. Silva2, A.L. Cunha2, C. Franco2, J. Oliveira2, I. Azevedo2, I. Pousa2, A. Rodrigues2, M. Soares2, D. Pereira2
  • 1Instituto Portugues de Oncologia Centro do Porto(IPO-Porto), 4200 - Porto/PT
  • 2Instituto Portugues de Oncologia Centro do Porto(IPO-Porto), Porto/PT

Abstract

Background

Pulmonary carcinoid (PC) tumors are a rare group of pulmonary neoplasms, characterized by neuroendocrine differentiation and indolent clinical behavior. Typical carcinoid (TC) account for the majority of cases, are low-grade and rarely metastasizes. Atypical carcinoid (AC) have worse prognosis, with greater tendency to metastasize and recur locally.

Methods

Retrospective analysis of histologically confirmed PCs diagnosed between 2008 and 2016. Descriptive analysis of the main demographic, clinical and prognostic characteristics was performed. Overall survival (OS) was evaluated using the Kaplan-Meier.

Results

We identified 55 patients (PTS). TC 58.2% (n = 32), AC 36.4% (n = 20), not other specified 3.6% (n = 2) and one case of combined TC and AC (bilateral). Female 56.4% (n = 31), male 43.6% (n = 24). Median age 62 years (range 18-83). Current smoker (SMK) 10.9% (n = 6), ex-SMK 10.9% (n = 6) and non-SMK 58.2% (n = 32). Secondary malignancies in 27.3% (n = 15) of PTS: thyroid (n = 4), breast (n = 3), prostate (n = 3), colorectal (n = 2), endometrium (n = 1), cervix (n = 1) and non-small lung cancer (n = 1). Staging (AJCC 7th Ed.): I (65.5%, n = 36), II (7.3%, n = 4), III (7.3%, n = 4), IV (16.4%, n = 9). Surgery was performed in 38 (86.3%) PTS with localized disease: lobectomy 78,9% (n = 30) pneumonectomy 13.2% (n = 5) and segmentectomy 7.9% (n = 3) and the majority (>90%) had systematic nodal dissection. One PT had adjuvant chemotherapy (CT) - stage IIIA. Recurrence was documented in 5 PTS submitted to complete resection. For advanced or recurrent disease, first line systemic treatment (Tx) was proposed in 9 PTS: somatostatin analogues (SA) (n = 3), CT (n = 3) and SA + CT (n = 3). The CT regimens were platinum + etoposide, streptozocin (STZ) + 5-FU and STZ + doxorubicin. Two PTS were treated after disease progression with further CT, one of them received 177Lutetium DOTA octreotide. 4 PTS underwent radiotherapy in palliative setting. Radioembolization was used to treat liver metastasis in 3 PTS. 5-year OS was 76,2%.

Conclusions

PC’s diagnosis and Tx require an experienced multidisciplinary team. Our results corroborate the literature data regarding epidemiology, high percentage of localized disease amenable for surgery and OS. Despite the emergence of new therapies, advanced disease remains with limited Tx options.

Clinical trial identification

Legal entity responsible for the study

Instituto Português de Oncologia do Porto

Funding

Instituto Português de Oncologia do Porto

Disclosure

All authors have declared no conflicts of interest.