Abstract 168P
Background
Lung carcinoid tumors, classified as typical and atypical, are neuroendocrine neoplasms with generally indolent behavior. The primary treatment is complete surgical resection, ranging from sublobar to more complex procedures, like broncoplastic resections, aimed at preserving lung function while ensuring negative margins. This study evaluates the outcomes of surgical treatment for lung carcinoids.
Methods
This retrospective cohort study examined patients with lung carcinoid tumors who underwent surgery between 2020 and 2024, in our center (9th edition TNM).
Results
A total of 57 patients were included, with a mean age of 61.9 ± 14.9 years; 52.6% were female, and 56.1% were non-smokers. No patients required neoadjuvant or adjuvant therapy. Preoperative diagnosis was established in 42 cases (73.7%). Among the carcinoid tumors, 22 had an endobronchial component; 2 cases produced ectopic ACTH, leading to Cushing syndrome, while 2 presented as multifocal carcinoid tumors and another 2 with synchronous adenocarcinoma in the same lobe. Lobectomy was the most common surgical procedure, performed in 78.9% of cases, including 9 bronchoplastic resections, 3 manual bronchial closures, and 1 bronchial sleeve anastomosis. Minimally invasive techniques, such as video-assisted and robotic surgery, were used in 77.2% of procedures. Typical carcinoid was the predominant histologic subtype (93.0%), with median tumor size of 17 mm. Only one patient revealed positive margins (R1) however MDT decided on surveillance, according to performance status. Final histopathology revealed stage IA in 68.4%, followed by stage IIB (10.5%), stage IB (8.7%), stage IIA (8.7%), and stage IIIA (3.5%), with malignant upstaging in only 12.3% of cases. Major operative morbidity was 8.8%. Mean follow-up time was 24.3 ± 18.2 months. Disease-free survival was 96.3% at 1 and 3 years and 89.4% at 5 years. Overall survival was 94.1% at 1 and 3 years and 85.5% at 5 years.
Conclusions
Surgical resection remains the cornerstone of treatment for lung carcinoid tumors, with encouraging survival outcomes and low recurrence rates, emphasizing the importance of early-stage diagnosis and a tailored surgical approach in optimizing patient outcomes.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.