• Prognostic significance of pulmonary multifocal neuroendocrine proliferation with typical carcinoid
  • Scarnecchia, Elisa <1985>

Subject

  • MED/21 Chirurgia toracica

Description

  • Background. Clinical significance of multifocal pulmonary neuroendocrine proliferations (MNEP), including tumorlets and pulmonary neuroendocrine cell hyperplasia, in association with Typical Carcinoid (TC), is still debated. Methods. A large retrospective series of TC with long-term follow-up data prospectively collected from two institutions was evaluated. Recurrence or new TC development was followed-up. Patients with TC alone and MNEP+TC were compared. Results. 234 TC patients undergone surgery were included: 41 MNEP+TC (17.5%) and 193 TC alone (82.5%). In the MNEP+TC group older age (p<0.001), peripheral tumors (p=0.0032), smaller tumor size (p=0.011) and lymph-nodal spread (p=0.02) were observed in comparison with TC group. Relapses occurred in 8 patients (19.5%) in the MNEP+TC group and in 7 (3.6%) of the TC group. The 10-years progression-free survival were 96.1% in TC and 83.8% in MNEP+TC (p<0.001). After matching, in 36 pairs of patients a significantly higher 5-years progression-free survival was calculated for TC group (p<0.01). Furthermore the odds of belonging to MNEP+TC group was higher with work-related exposure to inhalant agents (p=0.008), asthma/bronchitis (p=0.002), emphysema, fibrosis and inflammatory status (p=0.032), micronodules on the chest CT scan and respiratory insufficiency (p=0.036). Conclusions. The identification of MNEP requires careful pathological examination and postoperative follow-up. MNEP seems to be an adverse prognostic factor in patients with synchronous TC. Therefore, suspicion of MNEP during the pre-operative assessment should not be underestimated, enabling changes in the surgical strategy.

Date

  • 2021-03-26

Type

  • Doctoral Thesis
  • PeerReviewed

Format

  • application/pdf

Identifier

http://amsdottorato.unibo.it/9588/1/Tesi%20Scarnecchia.pdf

urn:nbn:it:unibo-27579

Scarnecchia, Elisa (2021) Prognostic significance of pulmonary multifocal neuroendocrine proliferation with typical carcinoid, [Dissertation thesis], Alma Mater Studiorum Università di Bologna. Dottorato di ricerca in Scienze cardio nefro toraciche , 33 Ciclo. DOI 10.6092/unibo/amsdottorato/9588.

Relations

http://amsdottorato.unibo.it/9588/