1. Recurrence Rates and Patterns after Radical Resection of Lung Carcinoids.
- Author
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Askildsen, Erika, Soldath, Patrick, Langer, Seppo W., Andreassen, Mikkel, Knigge, Ulrich, and Petersen, René Horsleben
- Subjects
CARCINOID ,CANCER relapse ,RETROSPECTIVE studies ,DESCRIPTIVE statistics ,LUNG tumors ,CONFIDENCE intervals ,PROPORTIONAL hazards models ,PATIENT aftercare - Abstract
Simple Summary: Lung carcinoids are known to be less malignant than other types of lung cancers. However, atypical lung carcinoids are more prone to recur after radical surgery than typical lung carcinoids. The aim of our retrospective study was to assess the rate of recurrence of low-stage atypical and typical carcinoids when accounting for competing events. We confirmed that atypical carcinoids recurred more often than typical carcinoids within 5 and 10 years after radical surgery. Atypical carcinoids at a low stage are more prone to recur after radical surgery, suggesting that all patients operated for atypical carcinoid should undergo close follow-up care after surgery. Atypical lung carcinoid (AC) is widely accepted to recur more often after radical resection than typical lung carcinoid (TC). However, their recurrence rates have never been compared in a multi-state competing risks model. We retrospectively reviewed files from patients with AC and TC who had been radically resected at our European Neuroendocrine Tumor Society Center of Excellence between 2009 and 2020. We estimated the recurrence rates between the AC and TC patients counting unrelated death as a competing event using Aalen–Johansen estimates and compared them using a multi-state Cox model. Finally, we analyzed all AC and TC recurrences as to resection type, pathological stage, resection margin, recurrence site, and time to recurrence. The study included 217 patients, of whom 194 had TC and 23 had AC. The median follow-up was 9.4 years. The AC patients experienced recurrence at a higher rate (hazard ratio [HR] 16.0, 95% confidence interval [CI] 5.3–47.9, p < 0.001). Correspondingly, the 5- and 10-year recurrence rates were 18% and 32% for AC and merely 1.0% and 2.4% for TC. In patients without nodal involvement, AC recurred at a considerably higher rate (HR 41.2, 95% CI 8.7–194.8, p < 0.001) than TC. In both AC and TC, most recurrences were distant and occurred in patients with a resection margin less than 2 cm. We conclude that AC recurs more often than TC, even in patients without nodal involvement at surgery, suggesting that all AC patients regardless of their pathological stage should undergo close follow-up care after surgery. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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