Typical and atypical carcinoid tumours:: analysis of the experience of the Spanish Multi-centric Study of Neuroendocrine Tumours of the Lung
Typical and atypical carcinoid tumours:: analysis of the experience of the Spanish Multi-centric Study of Neuroendocrine Tumours of the Lung
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DOI：
10.1016/j.ejcts.2006.11.031
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发表时间：
2007-02-01
影响因子：
3.4
通讯作者：
Muguruza, Ignacio
中科院分区：
文献类型：
--
作者：
Garcia-Yuste, Mariano;Matilla, Jose M.;Muguruza, Ignacio
背景资料：本研究探讨了西班牙肺神经内分泌肿瘤多中心研究的经验，手术治疗的典型和非典型类癌肿瘤的患者。方法：1980年至2002年，661例患者手术治疗的569例典型类癌和92例非典型类癌。回顾性分析1980 ~ 1997年304例（典型类癌261例，非典型类癌43例），前瞻性分析1998 ~ 2002年357例（典型类癌308例，非典型类癌49例）。根据WHO和国际肺癌研究协会（IASLC）的1999年分类对肿瘤进行分类。对所有患者的几个变量进行了审查。进行单变量和多变量统计分析，以确定临床特征是否与生存率的显著差异相关。结果如下：在所有患者中，不同肿瘤的5年生存率如下：典型类癌：总生存率97%;淋巴结受累100%;非典型类癌：总生存率78%;淋巴结受累60%。在回顾性和前瞻性组中，发现非典型类癌和淋巴结受累患者的生存率有显著差异。典型和非典型类癌肿瘤的几个因素的比较分析显示，平均年龄，肿瘤大小，淋巴结受累和远处转移的显着差异。结论：淋巴结转移和组织学类型是影响预后的重要因素。适当的肺切除术和系统的根治性纵隔淋巴结清扫术应始终进行。对于典型和不典型的中央型类癌，可采用袖状切除术，避免全肺切除。(c)2007年欧洲胸外科协会。Elsevier B. V.出版，保留所有权利。
Background: This study examines the experience of the Spanish Multi-centric Study of Neuroendocrine Tumours of the Lung with patients treated surgically for typical and atypical carcinoid tumours. Methods: From 1980 to 2002, 661 patients were treated surgically for 569 typical carcinoid tumours; and 92 atypical carcinoid tumours. Three hundred and four cases were studied retrospectively from 1980 to 1997 (261 typical carcinoid and 43 atypical carcinoid tumours); the other 357 new cases (308 typical carcinoid and 49 atypical carcinoid tumours) were collected prospectively from 1998 to 2002. Tumours were classified according the 1999 classification from the WHO and the International Association for the Study of Lung Cancer (IASLC). Several variables were reviewed in all patients. Univariate and multivariate statistical analyses were performed in order to determine whether clinical characteristics were associated with significant differences in survival. Results: In the total of the patients, 5-year survival for different tumours was as follows: typical carcinoid: overall survival 97%; with nodal involvement 100%; atypical carcinoid: overall 78%; with nodal involvement 60%. A significant difference in survival was found between patients in the retrospective and prospective groups with atypical carcinoid and nodal involvement. The comparative analysis of several factors in typical and atypical carcinoid tumours showed a significant difference for mean age, tumour size, nodal involvement and distant metastases. Conclusion: Nodal involvement and histological sub-type appear as the most important factors influencing the prognosis. Adequate Lung resection and systematic radical mediastinal lymphadenectomy should always be performed. Sleeve resection could be performed in central typical and atypical carcinoid tumours, avoiding pneumonectomy. (c) 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.