Schmidlin Moira, Sadowski Samira M, Siebenhüner Alexander, Wild Damian, Christ Emanuel, Refardt Julie
ENETS Center of Excellence for Neuroendocrine and Endocrine Tumors, University Hospital Basel, 4031 Basel, Switzerland.
Department of Clinical Research, University of Basel, 4031 Basel, Switzerland.
Cancers (Basel). 2023 Apr 13;15(8):2270. doi: 10.3390/cancers15082270.
Typical (TC) and atypical carcinoids (AC) are the most common neuroendocrine tumors (NETs) of the lung. Because these tumors are rare, their management varies widely among Swiss centers. Our aim was to compare the management of Swiss patients before and after the publication of the expert consensus of the European Neuroendocrine Tumor Society (ENETS) in 2015. We used data from the Swiss NET registry from 2009 to 2021 with patients with TC and AC. Survival analysis was performed using the Kaplan-Meier method and log-rank test. Overall, 238 patients were included, 76% (180) thereof with TC and 24% (58) with AC, including 155 patients before and 83 patients after 2016. An increase in the use of functional imaging was observed, 16% (25) before and 35% (29) after 2016, < 0.001. The presence of SST-receptors was determined more often: 32% (49 times) before 2016 and 47% (39 times) after, = 0.019. Concerning therapy, higher removal of lymph nodes after 2016 was observed, 54% (83) before versus 78% (65) after, < 0.001. Median overall survival for patients with AC was significantly shorter, with 89 months compared to 157 months for patients with TC, < 0.001. While the implementation of a more standardized approach was observed over the years, there is still room for amelioration in the management of TC and AC in Switzerland.
典型类癌（TC）和非典型类癌（AC）是肺部最常见的神经内分泌肿瘤（NETs）。由于这些肿瘤较为罕见，瑞士各中心对它们的治疗方法差异很大。我们的目的是比较2015年欧洲神经内分泌肿瘤学会（ENETS）专家共识发布前后瑞士患者的治疗情况。我们使用了瑞士NET登记处2009年至2021年的数据，纳入了TC和AC患者。采用Kaplan-Meier方法和对数秩检验进行生存分析。总体而言，共纳入238例患者，其中76%（180例）为TC，24%（58例）为AC，包括2016年前的155例患者和2016年后的83例患者。观察到功能成像的使用有所增加，2016年前为16%（25例），2016年后为35%（29例），P<0.001。SST受体的检测更为频繁：2016年前为32%（49次），2016年后为47%（39次），P = 0.019。关于治疗，观察到2016年后淋巴结清扫率更高，2016年前为54%（83例），2016年后为78%（65例），P<0.001。AC患者的中位总生存期明显较短，为89个月，而TC患者为157个月，P<0.001。虽然多年来观察到采用了更标准化的方法，但瑞士在TC和AC的治疗管理方面仍有改进空间。
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