Prognosis of Patients with Bronchopulmonary Neuroendocrine Neoplasms in a Tertiary Neuroendocrine Tumor Centre of Excellence

TY - JOUR

T1 - Prognosis of Patients with Bronchopulmonary Neuroendocrine Neoplasms in a Tertiary Neuroendocrine Tumor Centre of Excellence

AU - Rewitz, Karina Stubkjær

AU - Grønbæk, Henning

AU - Tabaksblat, Elizaveta Mitkina

AU - Dahl Baunwall, Simon Mark

AU - Dam, Gitte

N1 - S. Karger AG, Basel.

PY - 2022/11

Y1 - 2022/11

N2 - INTRODUCTION: The European Neuroendocrine Tumor Society, ENETS, reports variables of prognostic significance in bronchopulmonary neuroendocrine neoplasms. The aim of this study was to investigate prognostic factors, recurrence free survival (RFS) and overall survival (OS) for patients with typical carcinoid (TC), atypical carcinoid (AC) and large cell neuroendocrine carcinoma (LCNEC). Current follow-up practices vary as the evidence is sparse and we aimed to explore the relevance of routine bronchoscopy in follow-up.METHODS: A cohort study of 208 patients with bronchopulmonary neuroendocrine neoplasms (BP-NENs) followed at Aarhus University Hospital in 2008-2019. Kaplan-Meier method for RFS and OS were determined for the variables: primary tumor, primary treatment, smoking status, gender and histological subtypes.RESULTS: The study included 153 patients with TC, 29 with AC and 26 with LCNEC. Median follow-up was 48 months. The majority of patients (n = 191) received surgical resection, of which 22 (11%) recurred over time. Seventeen patients had non-surgical treatment, of which 10 (59%) progressed. The 5-year OS-rate were 86% for operated and 9% for non-operated patients (p < 0.05). Patients with TC had a 5-year OS of 90% com-pared with 63% and 39% for AC and LCNEC, respectively. As for prognostic factors non-smokers did not secure a significant difference in OS compared with current/previous smokers (p = 0.51). In the follow-up period only two (9%) of the 22 recurrences were found on a routine bronchoscopy. Both of these recurrences were also found by diagnostic imaging.CONCLUSIONS: Surgical treatment, especially, and diagnosis of TC was associated with a good prognosis. Further, our data did not support routine bronchoscopy as part of a follow-up program for bronchial carcinoids.

AB - INTRODUCTION: The European Neuroendocrine Tumor Society, ENETS, reports variables of prognostic significance in bronchopulmonary neuroendocrine neoplasms. The aim of this study was to investigate prognostic factors, recurrence free survival (RFS) and overall survival (OS) for patients with typical carcinoid (TC), atypical carcinoid (AC) and large cell neuroendocrine carcinoma (LCNEC). Current follow-up practices vary as the evidence is sparse and we aimed to explore the relevance of routine bronchoscopy in follow-up.METHODS: A cohort study of 208 patients with bronchopulmonary neuroendocrine neoplasms (BP-NENs) followed at Aarhus University Hospital in 2008-2019. Kaplan-Meier method for RFS and OS were determined for the variables: primary tumor, primary treatment, smoking status, gender and histological subtypes.RESULTS: The study included 153 patients with TC, 29 with AC and 26 with LCNEC. Median follow-up was 48 months. The majority of patients (n = 191) received surgical resection, of which 22 (11%) recurred over time. Seventeen patients had non-surgical treatment, of which 10 (59%) progressed. The 5-year OS-rate were 86% for operated and 9% for non-operated patients (p < 0.05). Patients with TC had a 5-year OS of 90% com-pared with 63% and 39% for AC and LCNEC, respectively. As for prognostic factors non-smokers did not secure a significant difference in OS compared with current/previous smokers (p = 0.51). In the follow-up period only two (9%) of the 22 recurrences were found on a routine bronchoscopy. Both of these recurrences were also found by diagnostic imaging.CONCLUSIONS: Surgical treatment, especially, and diagnosis of TC was associated with a good prognosis. Further, our data did not support routine bronchoscopy as part of a follow-up program for bronchial carcinoids.

KW - Bronchopulmonary neuroendocrine tumors

KW - Bronchoscopy

KW - Follow-up

KW - Prognosis

U2 - 10.1159/000525379

DO - 10.1159/000525379

M3 - Journal article

C2 - 35671706

SN - 0028-3835

VL - 112

SP - 1214

EP - 1224

JO - Neuroendocrinology

JF - Neuroendocrinology

IS - 12

ER -