Sublobar Resection in the Treatment of Peripheral Typical Carcinoid Tumors of the Lung

Maria Cattoni, Eric Vallières, Lisa M Brown, Amir A. Sarkeshik, Stefano Margaritora, Alessandra Siciliani, Pier Luigi Filosso, Francesco Guerrera, Andrea Imperatori, Nicola Rotolo, Farhood Farjah, Grace Wandell, Kimberly Costas, Catherine Mann, Michal Hubka, Stephen Kaplan, Alexander S. Farivar, Ralph W. Aye, Brian E. Louie

Research output: Contribution to journalArticle

Abstract

Background: The role of sublobar resection in the treatment of pulmonary typical carcinoids is controversial. This study aims to compare long-term outcomes between sublobar and lobar resections in patients with peripheral typical carcinoid. Methods: We retrospectively compared consecutive patients who underwent curative sublobar resection with patients who underwent lobectomy for cT1-3 N0 M0 peripheral pulmonary typical carcinoid in eight centers between 2000 and 2015. Primary outcomes were rates and patterns of recurrence and overall survival. Cox regression modeling was performed to identify factors influencing overall survival and recurrence. Propensity score analysis was done, and overall survival was compared between the two groups. Results: In all, 177 patients were analyzed, consisting of 74 sublobar resections and 103 lobectomies, with a total of 857 person-years of follow-up. The R1 resection rates were 7% and 1% after sublobar resection and lobectomy, respectively (P =.08). One of 5 patients with sublobar R1 resection had recurrence. Recurrence rate was 0.02 (95% confidence interval [CI]: 0.009 to 0.044) per person-year of follow-up after sublobar resection and 0.008 (95% CI: 0.003 to 0.02) after lobectomy (P =.15). Five-year survival rates were 91.7% (95% CI: 78.5% to 96.9%) and 97.4% (95% CI: 90.1% to 99.4%) after sublobar and lobar resection, respectively (P =.08). Extent of resection was not a predictor of recurrence or survival. Propensity score analysis confirmed a similar survival and freedom from recurrence between the two groups. Conclusions: Sublobar resection of peripheral cT1-3 N0 M0 pulmonary typical carcinoid was not associated with worse short- or long-term outcomes compared with lobectomy. In select patients, sublobar resection may be considered for treatment of peripheral typical carcinoids if an R0 resection is obtained.

Original languageEnglish (US)
Pages (from-to)859-865
Number of pages7
JournalAnnals of Thoracic Surgery
Volume108
Issue number3
DOIs
StatePublished - Sep 1 2019

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Carcinoid Tumor
Recurrence
Lung
Survival
Confidence Intervals
Propensity Score
Therapeutics
Survival Rate

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Cattoni, M., Vallières, E., Brown, L. M., Sarkeshik, A. A., Margaritora, S., Siciliani, A., ... Louie, B. E. (2019). Sublobar Resection in the Treatment of Peripheral Typical Carcinoid Tumors of the Lung. Annals of Thoracic Surgery, 108(3), 859-865. https://doi.org/10.1016/j.athoracsur.2019.04.005

Sublobar Resection in the Treatment of Peripheral Typical Carcinoid Tumors of the Lung. / Cattoni, Maria; Vallières, Eric; Brown, Lisa M; Sarkeshik, Amir A.; Margaritora, Stefano; Siciliani, Alessandra; Filosso, Pier Luigi; Guerrera, Francesco; Imperatori, Andrea; Rotolo, Nicola; Farjah, Farhood; Wandell, Grace; Costas, Kimberly; Mann, Catherine; Hubka, Michal; Kaplan, Stephen; Farivar, Alexander S.; Aye, Ralph W.; Louie, Brian E.

In: Annals of Thoracic Surgery, Vol. 108, No. 3, 01.09.2019, p. 859-865.

Research output: Contribution to journalArticle

Cattoni, M, Vallières, E, Brown, LM, Sarkeshik, AA, Margaritora, S, Siciliani, A, Filosso, PL, Guerrera, F, Imperatori, A, Rotolo, N, Farjah, F, Wandell, G, Costas, K, Mann, C, Hubka, M, Kaplan, S, Farivar, AS, Aye, RW & Louie, BE 2019, 'Sublobar Resection in the Treatment of Peripheral Typical Carcinoid Tumors of the Lung', Annals of Thoracic Surgery, vol. 108, no. 3, pp. 859-865. https://doi.org/10.1016/j.athoracsur.2019.04.005
Cattoni, Maria ; Vallières, Eric ; Brown, Lisa M ; Sarkeshik, Amir A. ; Margaritora, Stefano ; Siciliani, Alessandra ; Filosso, Pier Luigi ; Guerrera, Francesco ; Imperatori, Andrea ; Rotolo, Nicola ; Farjah, Farhood ; Wandell, Grace ; Costas, Kimberly ; Mann, Catherine ; Hubka, Michal ; Kaplan, Stephen ; Farivar, Alexander S. ; Aye, Ralph W. ; Louie, Brian E. / Sublobar Resection in the Treatment of Peripheral Typical Carcinoid Tumors of the Lung. In: Annals of Thoracic Surgery. 2019 ; Vol. 108, No. 3. pp. 859-865.
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abstract = "Background: The role of sublobar resection in the treatment of pulmonary typical carcinoids is controversial. This study aims to compare long-term outcomes between sublobar and lobar resections in patients with peripheral typical carcinoid. Methods: We retrospectively compared consecutive patients who underwent curative sublobar resection with patients who underwent lobectomy for cT1-3 N0 M0 peripheral pulmonary typical carcinoid in eight centers between 2000 and 2015. Primary outcomes were rates and patterns of recurrence and overall survival. Cox regression modeling was performed to identify factors influencing overall survival and recurrence. Propensity score analysis was done, and overall survival was compared between the two groups. Results: In all, 177 patients were analyzed, consisting of 74 sublobar resections and 103 lobectomies, with a total of 857 person-years of follow-up. The R1 resection rates were 7{\%} and 1{\%} after sublobar resection and lobectomy, respectively (P =.08). One of 5 patients with sublobar R1 resection had recurrence. Recurrence rate was 0.02 (95{\%} confidence interval [CI]: 0.009 to 0.044) per person-year of follow-up after sublobar resection and 0.008 (95{\%} CI: 0.003 to 0.02) after lobectomy (P =.15). Five-year survival rates were 91.7{\%} (95{\%} CI: 78.5{\%} to 96.9{\%}) and 97.4{\%} (95{\%} CI: 90.1{\%} to 99.4{\%}) after sublobar and lobar resection, respectively (P =.08). Extent of resection was not a predictor of recurrence or survival. Propensity score analysis confirmed a similar survival and freedom from recurrence between the two groups. Conclusions: Sublobar resection of peripheral cT1-3 N0 M0 pulmonary typical carcinoid was not associated with worse short- or long-term outcomes compared with lobectomy. In select patients, sublobar resection may be considered for treatment of peripheral typical carcinoids if an R0 resection is obtained.",
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AU - Cattoni, Maria

AU - Vallières, Eric

AU - Brown, Lisa M

AU - Sarkeshik, Amir A.

AU - Margaritora, Stefano

AU - Siciliani, Alessandra

AU - Filosso, Pier Luigi

AU - Guerrera, Francesco

AU - Imperatori, Andrea

AU - Rotolo, Nicola

AU - Farjah, Farhood

AU - Wandell, Grace

AU - Costas, Kimberly

AU - Mann, Catherine

AU - Hubka, Michal

AU - Kaplan, Stephen

AU - Farivar, Alexander S.

AU - Aye, Ralph W.

AU - Louie, Brian E.

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N2 - Background: The role of sublobar resection in the treatment of pulmonary typical carcinoids is controversial. This study aims to compare long-term outcomes between sublobar and lobar resections in patients with peripheral typical carcinoid. Methods: We retrospectively compared consecutive patients who underwent curative sublobar resection with patients who underwent lobectomy for cT1-3 N0 M0 peripheral pulmonary typical carcinoid in eight centers between 2000 and 2015. Primary outcomes were rates and patterns of recurrence and overall survival. Cox regression modeling was performed to identify factors influencing overall survival and recurrence. Propensity score analysis was done, and overall survival was compared between the two groups. Results: In all, 177 patients were analyzed, consisting of 74 sublobar resections and 103 lobectomies, with a total of 857 person-years of follow-up. The R1 resection rates were 7% and 1% after sublobar resection and lobectomy, respectively (P =.08). One of 5 patients with sublobar R1 resection had recurrence. Recurrence rate was 0.02 (95% confidence interval [CI]: 0.009 to 0.044) per person-year of follow-up after sublobar resection and 0.008 (95% CI: 0.003 to 0.02) after lobectomy (P =.15). Five-year survival rates were 91.7% (95% CI: 78.5% to 96.9%) and 97.4% (95% CI: 90.1% to 99.4%) after sublobar and lobar resection, respectively (P =.08). Extent of resection was not a predictor of recurrence or survival. Propensity score analysis confirmed a similar survival and freedom from recurrence between the two groups. Conclusions: Sublobar resection of peripheral cT1-3 N0 M0 pulmonary typical carcinoid was not associated with worse short- or long-term outcomes compared with lobectomy. In select patients, sublobar resection may be considered for treatment of peripheral typical carcinoids if an R0 resection is obtained.

AB - Background: The role of sublobar resection in the treatment of pulmonary typical carcinoids is controversial. This study aims to compare long-term outcomes between sublobar and lobar resections in patients with peripheral typical carcinoid. Methods: We retrospectively compared consecutive patients who underwent curative sublobar resection with patients who underwent lobectomy for cT1-3 N0 M0 peripheral pulmonary typical carcinoid in eight centers between 2000 and 2015. Primary outcomes were rates and patterns of recurrence and overall survival. Cox regression modeling was performed to identify factors influencing overall survival and recurrence. Propensity score analysis was done, and overall survival was compared between the two groups. Results: In all, 177 patients were analyzed, consisting of 74 sublobar resections and 103 lobectomies, with a total of 857 person-years of follow-up. The R1 resection rates were 7% and 1% after sublobar resection and lobectomy, respectively (P =.08). One of 5 patients with sublobar R1 resection had recurrence. Recurrence rate was 0.02 (95% confidence interval [CI]: 0.009 to 0.044) per person-year of follow-up after sublobar resection and 0.008 (95% CI: 0.003 to 0.02) after lobectomy (P =.15). Five-year survival rates were 91.7% (95% CI: 78.5% to 96.9%) and 97.4% (95% CI: 90.1% to 99.4%) after sublobar and lobar resection, respectively (P =.08). Extent of resection was not a predictor of recurrence or survival. Propensity score analysis confirmed a similar survival and freedom from recurrence between the two groups. Conclusions: Sublobar resection of peripheral cT1-3 N0 M0 pulmonary typical carcinoid was not associated with worse short- or long-term outcomes compared with lobectomy. In select patients, sublobar resection may be considered for treatment of peripheral typical carcinoids if an R0 resection is obtained.

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