Past Cases, Present Insights: Surgical Outcomes of Pulmonary Carcinoid Tumours - An Institutional Experience

Background and ObjectivesPulmonary carcinoid tumours are rare, representing 1-2% of all lung cancers. Surgical resection offers curative-intent treatment with 5-year survival rates of 50-70% for atypical carcinoid (AC) and 90% for typical carcinoid (TC) tumours. We review management and outcomes, including survival statistics and prognostic factors for recurrence over a 14-year period at our institution, the largest volume thoracic surgical oncology centre in Ireland.MethodsPatients who underwent surgical resection between January 1st 2010 and April 30th 2024 for pulmonary carcinoid tumours were identified. STATABE version 18.0 performed Fischer’s exact test and student’s t-test. Kaplan Meier graphs were used for survival analysis and Cox regression to assess prognostic factors.Results191 patients underwent surgical resection. 21% were upstaged from clinical N0. N2 disease (p=0.181, 95% CI: 0.55 – 24.42) and adjuvant chemotherapy (p=0.180, 95%, CI 0.54-26.48) were not statistically significant for overall survival. Mean time to recurrence was 37.5 (SD+-5.66) months; 2% of TC and 23% of AC recurred. No patient with Stage I disease recurred; 58% of recurrence was in Stage III atypical carcinoid tumours. Overall survival at 5-years was 96.3% (TC 98.7%, AC 87.7%) and 10-years was 93.8% (TC 98.7%, AC 73.7%).ConclusionOccult nodal disease occurred in 48% of atypical carcinoid tumours and adjuvant chemotherapy did not appear to yield a survival advantage. 58% of recurrences occurred in Stage III atypical carcinoid tumours. Early diagnosis remains paramount as surgical resection of pulmonary carcinoid tumours yields an excellent overall survival at 5-years of 96.3% and 10-years of 93.8%.