Lung Carcinoids: Long-Term Surgical Results and the Lack of Prognostic Value of Somatostatin Receptors and Other Novel Immunohistochemical Markers

Abstract

Background/Aims: Lung carcinoids (LCs) are often diagnosed at an early stage and surgical intervention becomes the next phase of treatment. To date, there is lack of long-term follow-up data after surgery and prognostication based on WHO classification criteria and evolving prognostic markers, particularly the expression of somatostatin receptors (SSR). Methods: We included 102 consecutive patients (72 women; age at baseline 51 ± 16 years [mean ± SD]) with LCs, who underwent thoracic surgery (n = 99) and/or laser treatment (n = 8). Hospital charts were reviewed for clinico-pathological parameters. Immunohistochemical (IHC) expression of SSR1–5 and other novel markers were studied with regard to their prognostic value. Results: Five- and 10-year overall survival (OS) was 96 and 83% respectively; relative survival (RS) was 101 and 93% respectively; and event-free survival (EFS) was 80 and 67% respectively. Independent prognostic factors for OS, RS and/or EFS were age at diagnosis, histopathological type and the presence of ipsilateral mediastinal subcarinal lymph node metastases. Macro-radicality of resective surgery and its extent were associated with increased OS and EFS. The IHC expression of SSR1–5 and other novel markers was not associated with OS or EFS. Conclusion: The long-term outcome of surgically treated patients with LCs is favourable. Age, histopathological type and ipsilateral mediastinal subcarinal lymph node status at baseline were independent prognostic factors for survival and disease recurrence or progression. The extent of surgery and operative macro-radicality also had an impact on prognosis. None of the IHC markers tested appeared to be associated with disease prognosis.

Pulmonary carcinoid tumours: A multi-centre analysis of survival and predictors of outcome following sublobar, lobar, and extended pulmonary resections

“…While some authors found that AC tends to occur in older patients, we found that median age did not differ between TC and AC, and overall median age of 57.7 years at the time of surgery was consistent with other series reported in the literature. Multiple authors have reported that age at the time of diagnosis is a significant prognostic factor for OS, 7–10 and our results support that also, with those aged greater than 60 years having four times higher hazard ratios.…”

Pulmonary Carcinoid Surface Receptor Modulation Using Histone Deacetylase Inhibitors

“…As previously reported, there is evidence that the interaction of somatostatin and its’ analogs with somatostatin receptors has an antiproliferative action and can induce apoptosis, in addition to inhibiting tumorigenic hormone and growth factor secretion [8,9]. Furthermore, there is evidence that patients with low tumor SSTR expression have poor prognoses [15,25,26]. Therefore, one would expect that an increase in SSTR2 could improve patient outcome from a molecular level.…”

Prognostic nomogram for predicting long-term survival in bronchopulmonary carcinoid tumor patients receiving resection

“…However, it may not be a perfect predictor of lung carcinoid tumor prognosis (13). Previous studies have shown that age, atypical histology, lymph node metastases, and a higher Ki-67 index were independent prognostic predictors of BPCs (9,(14)(15)(16). However, these factors only predicted the prognosis of BPCs unilaterally.…”