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 language | English (US) |
|---|---|
| Pages (from-to) | 859-865 |
| Number of pages | 7 |
| Journal | Annals of Thoracic Surgery |
| Volume | 108 |
| Issue number | 3 |
| DOIs | |
| State | Published - Sep 1 2019 |
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ASJC Scopus subject areas
- Surgery
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine
Cite this
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 journal › Article
}
TY - JOUR
T1 - Sublobar Resection in the Treatment of Peripheral Typical Carcinoid Tumors of the Lung
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.
PY - 2019/9/1
Y1 - 2019/9/1
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.
UR - http://www.scopus.com/inward/record.url?scp=85070891913&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85070891913&partnerID=8YFLogxK
U2 - 10.1016/j.athoracsur.2019.04.005
DO - 10.1016/j.athoracsur.2019.04.005
M3 - Article
C2 - 31059684
AN - SCOPUS:85070891913
VL - 108
SP - 859
EP - 865
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
SN - 0003-4975
IS - 3
ER -