Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen, Denmark; ENETS Neuroendocrine Tumor Centre of Excellence Rigshospitalet, University of Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Denmark; ENETS Neuroendocrine Tumor Centre of Excellence Rigshospitalet, University of Copenhagen, Denmark.
Lung Cancer. 2021 Jun;156:109-116. doi: 10.1016/j.lungcan.2021.04.010. Epub 2021 Apr 26.
The aim of this study was to determine overall survival and recurrence-free survival after resection of bronchopulmonary carcinoids by means of predominantly minimally invasive surgery and lung-sparing resections. In addition, we aimed to identify prognostic factors for overall survival.
Retrospective review of consecutive patients operated for bronchopulmonary carcinoids between January 2009 and October 2020 identified from a prospectively collected database.
A total of 236 patients representing 240 cases of bronchopulmonary carcinoids were included. Of these, 212 (88.3 %) were typical carcinoids, while 28 (11.7 %) were atypical carcinoids. A Video-Assisted Thoracoscopic Surgery (VATS) approach was used in 75 % of cases. There was no 30-day mortality. The median follow-up was 5.6 years for overall survival and 4.7 years for recurrence-free survival. 5- and 10-year overall survival rates were 89 % and 71 %, while 5- and 10-year recurrence-free survival rates were 84 % and 71 %. Patients with atypical carcinoids had significantly reduced overall survival and recurrence-free survival rates (HR 3.4; 95 % CI 1.5-7.6; p = 0.003 and HR 5.4; 95 % CI 2.6-11.4; p < 0.001). Independent predictors of overall survival included atypical carcinoid (HR 2.7; 95 % CI 1.2-6.0; p = 0.018) and age > 60 years (HR 2.9; 95 % CI 1.2-7.3; p = 0.021).
Surgery for bronchopulmonary carcinoids by means of predominantly VATS and lung-sparing resections provides favorable long-term survival. Atypical carcinoids and age > 60 years are independent predictors of poor overall survival.
本研究旨在通过主要采用微创外科手术和保肺切除术来确定支气管肺类癌切除术后的总生存率和无复发生存率。此外，我们旨在确定总生存率的预后因素。
回顾性分析 2009 年 1 月至 2020 年 10 月期间从一个前瞻性收集的数据库中连续手术治疗的支气管肺类癌患者。
共纳入 236 例 240 例支气管肺类癌患者，其中典型类癌 212 例（88.3%），非典型类癌 28 例（11.7%）。75%的病例采用电视胸腔镜手术（VATS）。无 30 天死亡率。总生存的中位随访时间为 5.6 年，无复发生存率为 4.7 年。5 年和 10 年总生存率分别为 89%和 71%，5 年和 10 年无复发生存率分别为 84%和 71%。非典型类癌患者的总生存率和无复发生存率明显降低（HR 3.4；95%CI 1.5-7.6；p=0.003 和 HR 5.4；95%CI 2.6-11.4；p<0.001）。总生存率的独立预测因素包括非典型类癌（HR 2.7；95%CI 1.2-6.0；p=0.018）和年龄>60 岁（HR 2.9；95%CI 1.2-7.3；p=0.021）。
主要采用 VATS 和保肺切除术治疗支气管肺类癌可提供良好的长期生存率。非典型类癌和年龄>60 岁是总生存率不良的独立预测因素。
