Document Detail


Is sublobar resection sufficient for carcinoid tumors?
MedLine Citation:
PMID:  21704299     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The existing guidelines for extent of resection of carcinoid tumors are based on other, more malignant non-small cell lung cancers. Because of the small number of patients in any single institution, we analyzed the Surveillance Epidemiology and End Results (SEER) database to study the effect of the extent of resection of these tumors on overall survival.
METHODS: All patients with lung cancer in the SEER database from 1973 to 2006 with carcinoid tumors as their only cancer were included. Variables examined included age, race (white, black, others), gender, histologic type (atypical versus typical carcinoid), stage (localized, regional, and distant), extent of resection (sublobar resection, lobectomy, or more extensive) and survival. Univariate analyses (Kaplan-Meier method) were used to select variables for multivariate analysis (Cox regression analysis). Associations were considered significant with an alpha error < 5%. In addition, propensity score-matched Cox regression analysis was performed for patients with typical carcinoid disease.
RESULTS: Most patients with carcinoid tumors did not acquire any other cancers (4,785/6,819; 70.2%). Of these, 797 patients had sublobar resection and 2,681 patients had lobectomy or more extensive resections. On univariate analysis, gender (p = 0.014), race (p < 0.001), stage (p < 0.001), histologic type (p < 0.001) and extent of resection (p = 0.04) were associated with overall survival. Multivariate analysis demonstrated that age, gender, race, stage, and histologic type remain statistically associated with overall survival and disease-specific survival, whereas extent of resection is not. Propensity score-matched analysis demonstrates that for typical carcinoid, extent of resection is not associated with overall survival when adjusted for age, gender, race, and stage.
CONCLUSIONS: Sublobar resection of carcinoid tumors did not compromise oncologic outcomes in a large population-based database. Lobectomy for typical carcinoid tumors is not mandatory as long as complete resection and adequate mediastinal staging are performed.
Authors:
Sai Yendamuri; David Gold; Vijay Jayaprakash; Elisabeth Dexter; Chukwumere Nwogu; Todd Demmy
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Publication Detail:
Type:  Journal Article     Date:  2011-06-24
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  92     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-04     Completed Date:  2011-12-27     Revised Date:  2013-02-08    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1774-8; discussion 1778-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, New York 14263, USA. sai.yendamuri@roswellpark.org
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MeSH Terms
Descriptor/Qualifier:
Carcinoid Tumor / mortality,  surgery*
Databases, Factual
Female
Humans
Lung Neoplasms / mortality,  surgery*
Male
Middle Aged
Pneumonectomy / methods*
Retrospective Studies
SEER Program
Survival Rate
Comments/Corrections
Comment In:
Ann Thorac Surg. 2011 Nov;92(5):1779   [PMID:  22051273 ]
Ann Thorac Surg. 2013 Jan;95(1):385   [PMID:  23272880 ]
Ann Thorac Surg. 2013 Jan;95(1):385-6   [PMID:  23272879 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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