Clinicopathological characteristics and survival outcomes of typical and atypical pulmonary carcinoid tumors: A 13-year single-center retrospective study.

Abstract

e20090 Background: Pulmonary neuroendocrine neoplasms (NENs) range from low-grade typical and atypical carcinoids to high-grade, poorly differentiated tumors such as large-cell and small-cell lung carcinoma. Pulmonary NENs account for approximately 20–30% of all neuroendocrine tumors and are classified as typical or atypical carcinoids based on mitotic count per high-power field and the presence of necrosis. This study evaluated the association between clinicopathological features, treatment modalities, and prognostic outcomes in patients with NENs treated at the National Research Institute of Tuberculosis and Lung Disease (NRITLD), Masih Daneshvari Hospital. Methods: In this retrospective cross-sectional study, pathology records of patients diagnosed with pulmonary neuroendocrine tumors between 2007 and 2020 were reviewed. Demographic data, pathological features, treatment modalities, and survival outcomes were collected. P < 0.05 was considered significant. Results: A total of 186 patients were included, of whom 164 (88.1%) had typical carcinoid tumors, and 22 (11.9%) had atypical carcinoids. Patients with atypical pulmonary carcinoids experienced higher rates of disease progression and metastasis and worse observed survival outcomes than those with typical carcinoids (P-values 0.0004,0.0001 and 0.0001, respectively). Surgery alone was the most common treatment modality in typical carcinoids (89.1%), whereas combined surgical resection and chemotherapy was most frequently used in atypical carcinoids (16.7%). The 1-year survival rates for atypical and typical carcinoids were 95.2% and 98.2%, respectively, while the corresponding 3-year survival rates were 89.6% and 95.7%. Conclusions: Atypical pulmonary carcinoids are associated with significantly higher rates of disease progression and metastasis and demonstrate inferior survival outcomes compared with typical carcinoids. These findings highlight the importance of early diagnosis and tailored treatment strategies to improve outcomes in patients with atypical pulmonary carcinoids. Clinicopathological characteristics and outcomes of patients. Pathologic results P-Value Overall n(%) Typical Carcinoid Tumors(n=164,88.1%) Atypical Carcinoid Tumors Age (Mean±SD a ) 43.67±15.78 42.92 ±15.87 49.18±14.33 0.081 SexFemaleMale 100(53.8)86(46.2) 90(54.87)74(45.13) 10(45.45)12(44.55) 0.405 Smoking StatusSmokerNon-Smoker 10(504)176(9406) 7(4.3)157(95.7) 3(30)19(70) 0.067 Vital statusAliveDead 175(94.1)11(5.9) 158(96.3)6(3.7) 17(77.3)5(22.7) 0.0004 * MetastasisNoYes 181(97.3)5(2.7) 163(99.4)1(0.6) 18(81.8)4(18.2) <0.0001 * Disease ProgressionYesNo 24(12.9)162(87.1) 15(9.1)149(90.9) 9(40.9)13(59.1) <0.0001 * *Significant P-value. Abbreviation: a; SD: standard deviation.