Bronchopulmonary carcinoid tumors: long-term outcomes after resection

Background: Bronchopulmonary carcinoid tumors are considered as a relatively uncommon and less malignant group of lung cancers. However, patients with histologically atypical disease are known to have a worse prognosis. The present study aims to evaluate the long-term outcomes after resection of bronchopulmonary carcinoid tumors according to the new tumor, nodes, metastasis (TNM) staging system.

Methods: Patients with histologically proven bronchopulmonary carcinoid tumors who underwent surgery in our thoracic unit over the last 25 years were identified from a prospectively collected database.

Results: One hundred and eighty-six patients were identified from our electronic database. Of these, 164 were known to have typical disease, while 22 had atypical disease. Median overall survival was 20.0 years. The mean follow-up was 8.0 years (median 7.0 years). Univariate analysis found age over 60, atypical disease, TNM staging, N status, and M status to have a statistically significant influence on overall survival. Multivariate analysis found age over 60 and atypical histopathology to have a detrimental impact on overall survival. Patients in the atypical subgroup were found to be significantly older, and presented with higher stage disease.

Conclusions: It is clear from the current study and previous reports that patients with atypical histopathology have different baseline characteristics, disease behavior, and prognosis compared with patients with typical disease. The proposed TNM staging system appears to be applicable to patients in our surgical experience, and may offer more accurate prognostic information and assist in the management plans for individuals.