Open AccessWell‐differentiated bronchial neuroendocrine tumors: Clinical management and outcomes in 105 patients
Author(s) -
Pericleous Marinos,
Karpathakis Anna,
Toumpanakis Christos,
Lumgair Heather,
Reiner Jonathan,
Marelli Laura,
Thirlwell Christina,
Caplin Martyn E.
Publication year - 2018
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12603
Subject(s) - medicine , neuroendocrine tumors , stage (stratigraphy) , chromogranin a , retrospective cohort study , gastroenterology , immunohistochemistry , paleontology , biology
Bronchial neuroendocrine tumors (NETs) are rare tumors representing approximately 20%‐30% of all neuroendocrine tumors and 2%‐3% of all adult lung cancers. Here, they present a large case series of well‐differentiated bronchial NETs with the aim of investigating the behavior of these tumors and long‐term outcomes. Methods A retrospective review was performed of 105 patients with bronchial NETs managed in a tertiary referral center in the period between January 1998 and January 2012. Results Bronchial NETs are commoner in females and the commonest presenting symptoms were cough (13.9%) and dyspnoea (11.6%). Octreoscan TM and Gallium‐68 DOTATATE PET were found to have similar diagnostic sensitivity and FDG PET was more sensitive for higher‐grade tumors. Over a median follow‐up period of 35.5 months mortality rate was 5.7%. The 5‐year survival was 76% and the 10‐year survival was 62%. Female patients survived longer but this difference was not statistically significant ( P = .59). Older age greater than 50 years ( P = .027), higher levels of Chromogranin A (CgA) ( P = .034), first‐line treatment with surgery ( P = .005), ki67 over 10% ( P = .037), and tumor stage ( P = .036) but not tumor grade ( P = .22), were significantly associated with survival. Discussion Several factors have been identified which are independently associated with survival including CgA levels greater than 100 pmol/L, tumor stage, age greater than 50, ki67 over 10% and having surgery as first‐line treatment. There was no difference in survival between typical and atypical carcinoids.