Surgical treatment of low and intermediate grade lung net

Yuste, Mariano García; Matilla, José-María; Cañizares, M.A.; Molins, Laureano; Guijarro, Ricardo

doi:10.21037/jtd.2017.09.83

Cited by 12 publications

(14 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Overall, distant metastases arising from resected typical carcinoids are rare (~3%). [40, 41] To our knowledge, this is the first documentation that when distant metastases do occur, typical carcinoids have the capacity to develop elevated – and in some instances substantially elevated – proliferation rates. These data indicate that proliferation rate is a dynamic variable during metastatic progression, and the diagnosis of typical carcinoid in the primary tumor does not assure low proliferation rate in metastases.…”

Section: Discussionmentioning

confidence: 93%

Stage IV lung carcinoids: spectrum and evolution of proliferation rate, focusing on variants with elevated proliferation indices

et al. 2019

View full text Add to dashboard Cite

The spectrum and evolution of proliferation rates in stage IV lung carcinoids is poorly defined. In particular, there are limited data on the prevalence and characteristics of tumors exceeding the standard upper proliferative criteria – as defined largely based on early-stage carcinoids – in metastatic setting.Sixty-six patients with stage IV lung carcinoids were identified, and all evaluable samples (n=132; mean 2 samples per patient) were analyzed for mitotic counts and Ki-67 rate. Clinicopathologic and genomic features associated with elevated proliferation rates (>10 mitoses per 2 mm2 and/or >20% hot-spot Ki-67), and evolution of proliferation rates in serial specimens were analyzed.We found that mitoses and/or Ki-67 exceeded the standard criteria in 35 of 132 (27%) samples, primarily (31/35 cases) from metastatic sites. Although neuroendocrine neoplasms with >10 mitoses per 2 mm2 are currently regarded as de facto neuroendocrine carcinomas, the notion that these cases are part of the spectrum of carcinoids was supported by 1) well-differentiated morphology, 2) conventional proliferation rates in other samples from same patient, 3) genetic characteristics, including the lack of RB1/TP53 alterations in all tested samples (n=19), and 4) median overall survival of 2.7 years, compared to <1 year survival of stage IV neuroendocrine carcinomas in the historic cohorts. In patients with matched primary/metastatic specimens (48 pairs), escalation of mitoses or Ki-67 by ≥10-points was observed in 35% of metastatic samples; clonal relationship in one pair with marked proliferative progression was confirmed by next-generation sequencing. Notably, escalation of proliferation rate was documented in a subset of metastases arising from resected typical carcinoids, emphasizing that the diagnosis of typical carcinoid in primary tumor does not assure low proliferation rate at metastatic sites.In conclusion, stage IV lung carcinoids frequently exceed the standard proliferative criteria established for primary tumors, and commonly exhibit proliferative escalation at metastatic sites. Despite the overlap of proliferation rates, these tumors show fundamental morphologic, genomic and clinical differences from neuroendocrine carcinomas, and should be classified separately from those tumors. Awareness of the increased proliferative spectrum in metastatic carcinoids is critical for their accurate diagnosis. Further studies are warranted to explore the impact of proliferation indices on prognosis and therapeutic responses of patients with metastatic carcinoids.

show abstract

Section: Discussionmentioning

confidence: 93%

Stage IV lung carcinoids: spectrum and evolution of proliferation rate, focusing on variants with elevated proliferation indices

et al. 2019

View full text Add to dashboard Cite

show abstract

“…LCs occur during the fifth or sixth decade of life for TC and a decade later for AC. [4][5][6][7][8][9][10] ThC is an extremely rare tumour accounting for an ageadjusted rate of 0.02/100 000-0.18/100 000/year in the European or USA populations, respectively. 3,11 In the Netherlands cancer registry or the Surveillance, Epidemiology and End Results (SEER) programme database, <0.5% of all neuroendocrine neoplasms were ThC, representing 5% of thymic tumours.…”

mentioning

confidence: 99%

Lung and thymic carcinoids: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up☆

et al. 2021

View full text Add to dashboard Cite

“…noted the same. 14 The presence of nodal involvement carries significant implications. Firstly, lymphadenopathy on pre-operative imaging should prompt the clinician to consider the tumour as being atypical in nature, and therefore, more aggressive in its oncological behaviour.…”

Section: Commentmentioning

confidence: 99%

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

Thakur

Florisson

Telianidis

et al. 2021

Asian Cardiovasc Thorac Ann

View full text Add to dashboard Cite

Background 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. Methods 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. Results 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). Conclusion 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.

show abstract

Surgical treatment of low and intermediate grade lung net

Cited by 12 publications

References 21 publications

Stage IV lung carcinoids: spectrum and evolution of proliferation rate, focusing on variants with elevated proliferation indices

Stage IV lung carcinoids: spectrum and evolution of proliferation rate, focusing on variants with elevated proliferation indices

Lung and thymic carcinoids: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up☆

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

Contact Info

Product

Resources

About