Prognostic factors in typical and atypical pulmonary carcinoids

Robert A. Ramirez, David T. Beyer, Anne E. Diebold, Brianne A. Voros, Maria M. Chester, Yi Zarn Wang, J. Philip Boudreaux, Eugene A. Woltering, Ann Porter Uhlhorn, Pamela Ryan, Richard J. Campeau, Lowell B. Anthony

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Background: Typical and atypical carcinoids represent approximately 2% of all lung tumors. Survival of patients with typical bronchial carcinoids, unlike the survival of patients with most lung tumors, is generally long but dependent on stage. We report the findings of the Ochsner Medical Center/Louisiana State University (LSU) Health Sciences Center neuroendocrine tumor (NET) program. Methods: A database with all patients seen at the Ochsner Medical Center/LSU NET program was queried for patients with bronchopulmonary NET. We included patients who had confirmed pathologic bronchopulmonary carcinoid and who had at least 1 clinic visit. Patients with large or small cell NETs or diffuse idiopathic pulmonary neuroendocrine cell hyperplasia were excluded. Results: A total of 169 patients seen from January 1996 to March 2015 met the inclusion criteria. The mean age at diagnosis was 53 years. Of the tumors, 51% percent (86/169) were well-differentiated, 12% (21/169) were moderately differentiated, and 85% and 53% were positive on positron emission tomography and octreotide scanning, respectively. The 5- and 10-year survival rates were 88% and 81% for well-differentiated tumors and 80% and 42% for moderately differentiated tumors, respectively. The 10-year survival rates stratified by Ki-67 index ranges 0-2%, >2%-10%, and >10% were 90%, 72%, and 44%, respectively (P<0.05). Conclusion: Overall, patients with bronchial carcinoids have long 5- and 10-year survival rates. We found significant survival differences between nodal status, differentiation status, and carcinoid phenotype. Interestingly, the difference in survival stratified by Ki-67 indices was statistically significant despite its absence in the World Health Organization grading system. As with gastroenteropancreatic NETs, Ki-67 index could become a valuable prognostic indicator for bronchial carcinoids.

Original languageEnglish
Pages (from-to)335-340
Number of pages6
JournalOchsner Journal
Volume17
Issue number4
DOIs
StatePublished - Dec 1 2017

Bibliographical note

Funding Information:
Robert A. Ramirez, DO, is a consultant for Ipsen Biopharmaceuticals, Inc. and BioTheranostics, Inc. as well as a speaker for Merck & Co., Inc., Genentech, Astra Zeneca, and Ipsen Biopharmaceuticals, Inc. Eugene A. Woltering, MD, is a speaker and consultant for Intersciences Institute, Ipsen Biopharmaceuticals, Inc., and Lexicon Pharmaceuticals, Inc. J. Philip Boudreaux, MD, is a speaker for Ipsen Biopharmaceuticals Inc. and Lexicon Pharmaceuticals, Inc. Pamela Ryan is a speaker and consultant for Ipsen Biopharmaceuticals, Inc. No other authors have conflicts of interest to disclose. Portions of this manuscript were previously presented at the 16th World Conference on Lung Cancer held September 6-9, 2015, in Denver, CO (abstract number 2858).

Publisher Copyright:
© Academic Division of Ochsner Clinic Foundation.

Keywords

  • Carcinoid tumor
  • Ki-67 antigen
  • Lung cancer

ASJC Scopus subject areas

  • General Medicine

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