Department of Cardiothoracic Surgery, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
Department of Thoracic Surgery, Austin Hospital, Heidelberg, Victoria, Australia.
Asian Cardiovasc Thorac Ann. 2021 Jul;29(6):532-540. doi: 10.1177/02184923211010090. Epub 2021 Apr 14.
Pulmonary carcinoids are rare neoplasms, accounting for approximately 1%-2% of all lung malignancies. A retrospective analysis was undertaken of all patients who underwent surgical resection of pulmonary carcinoid tumours across multiple institutions in Melbourne, Australia.
From May 2000 through April 2020, 241 patients who underwent surgical resection of pulmonary carcinoid tumours were retrospectively reviewed. Patient demographics, pathologic data, and long-term outcomes were recorded.
Median age was 57.7 years and the majority of patients were female (58.9% vs. 41.1%). Typical carcinoid was present in 77.1%. Histological subtype was associated with several factors. Atypical carcinoid was more likely to have larger tumour size and nodal involvement. Overall survival for typical carcinoid at 5, 10, and 15 years was 98%, 95%, and 84%, and for atypical carcinoid was 88%, 82%, and 62%, respectively. Histological subtype and age were found to be independent predictors of overall survival, with worse outcomes for atypical and those above 60 years of age. Disease-free survival was related to sublobar resection (p < 0.001, sub-hazard ratio (SHR): 6.89), lymph node involvement (p = 0.022, SHR: 3.18), and atypical histology (p < 0.001, SHR: 9.89).
Excellent long-term outcomes can be achieved following surgical resection of pulmonary carcinoids. Atypical histology and lymph node involvement are significant prognostic factors, and sublobar resection should not be considered in patients with either of the above features. Typical carcinoid tumour without nodal involvement may be appropriate for sublobar resection. Typical and atypical carcinoid tumours should be considered distinct disease entities, and as such treated accordingly.
肺类癌是罕见的肿瘤，约占所有肺部恶性肿瘤的 1%-2%。对澳大利亚墨尔本多家机构接受肺类癌肿瘤手术切除的所有患者进行了回顾性分析。
从 2000 年 5 月至 2020 年 4 月，回顾性分析了 241 例接受肺类癌肿瘤手术切除的患者。记录了患者的人口统计学、病理数据和长期结果。
中位年龄为 57.7 岁，大多数患者为女性（58.9%比 41.1%）。存在典型类癌占 77.1%。组织学亚型与多种因素有关。不典型类癌更有可能肿瘤体积较大且有淋巴结受累。典型类癌的 5 年、10 年和 15 年总生存率分别为 98%、95%和 84%，不典型类癌分别为 88%、82%和 62%。组织学亚型和年龄被发现是总生存率的独立预测因素，不典型和年龄超过 60 岁的患者预后较差。无病生存率与亚肺叶切除（p<0.001，亚危险比（SHR）：6.89）、淋巴结受累（p=0.022，SHR：3.18）和不典型组织学（p<0.001，SHR：9.89）有关。
肺类癌患者行手术切除后可获得良好的长期结果。不典型组织学和淋巴结受累是重要的预后因素，对于有上述特征的患者不应考虑亚肺叶切除。无淋巴结受累的典型类癌肿瘤可能适合亚肺叶切除。典型类癌和不典型类癌应被视为不同的疾病实体，并相应进行治疗。
