Long-term outcomes and prognostic factors of patients with pulmonary carcinoid tumors

The aim of the study was to evaluate type of surgery, long-term survival and factors influencing outcome of pulmonary carcinoid tumors. We reviewed our database of 137 patients surgically treated for typical or atypical carcinoid tumors at our department between 1998 and 2013. There were 95 (69%) patients with typical carcinoid (87 N0, 6 N1, 2 N2) and 42(31%) with atypical carcinoid (26 N0, 8 N1, 8 N2). Patients with atypical carcinoid were older than those with typical carcinoid (median age of 57 +/- 8.1 and 50.5 +/- 15.8 years, respectively, p<0.00001). The resection performed consisted of 6 (4.4%) pneumonectomies, 110 (80.1%) lobectomies and bilobectomies, 15 (11%) sleeve lobectomies, 2 (1.5%) resections of main bronchus and 4 (3%) wedge resections. Overall 5- and 10-year survival rates for different tumors were as follows: typical carcinoid: 97.2% and 89.9%, respectively; atypical carcinoid 71.1% and 62.2%, respectively. Statistical analyses indicated that histology (typical carcinoid, p<0.00001), age (less than 45 years, p=0.004) and nodal status (N0, p=0.0002) were significant prognostic factors for better prognosis. Histological sub-type and nodal involvement appear as the most important factors influencing the prognosis. Systemic lymphadenectomy is recommended and should always be performed.