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A. Ribeiro



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    Poster Display session (Friday) (ID 65)

    • Event: ELCC 2018
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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      224P - The role of surgery in the treatment of lung neuroendocrine tumors (NETs) based on a 3-year experience of a thoracic department (ID 484)

      12:30 - 13:00  |  Author(s): A. Ribeiro

      • Abstract
      • Slides

      Background:
      NETs are a heterogeneous family of neoplasms comprising typical and atypical carcinoid (TC and AC), large-cell neuroendocrine carcinoma (LCNEC) and small cell lung carcinoma (SCLC). Surgical resection is the primary therapy for carcinoid tumors of the lung but plays a minor role in treatment of SCLC and LCNEC because tumors are often locally advanced or have metastasized at the time of presentation. Patients with limited cancer may demonstrate better disease control upon surgical treatment.

      Methods:
      Retrospective analysis of histologically confirmed lung NETs submitted to surgical treatment between 2015 and 2017 in a thoracic surgery unit of a tertiary hospital. Descriptive analysis of the main demographic, clinical, imagiological features and surgical treatment was performed.

      Results:
      Of the 1799 patients admitted on the unit, included 72 patients. 24 TC (33.4%), 32 AC (44.4%), 14 LCNEC (19.4%) and 2 SCLC (2.8%). 58.3% (n = 42) were female. The median age was 65 years (range 24–83) without difference by gender. Current smoker (SMK) 19.4% (n = 14), ex-SMK 26.4% (n = 19) and non-SMK 54.2% (n = 39). Median lesion dimension in CT scan was 25.7 mm, located in 2 lobes in 9 patients. PET was performed in 90% patients with median 6.3 SUV. Airway obstruction in 18% of patients. Lobectomy performed in 72.2% (52 patients, 6 of them involving 2 lobes) and segmentectomy performed in 27.8% (20 patients, 5 of them involving 2 lobes). The surgical approach was thoracotomy in 58.3% (n = 42) and minimally invasive (VATS) in 41.7% (n = 30). The mean length of stay was 10 days. The median pathological lesion size was 33.2 × 21.5 × 6 mm; Ki-67 antigen expression was evaluated in 43% patients (n = 31). Staging: I (65.3%, n = 47), II (20.9%, n = 15), III (6.9%, n = 5), IV (6.9%, n = 5). 92% TC were stage I; 15.6% AC were stage III and IV; 28.6% LCNEC were stage III and IV.

      Conclusions:
      This study reinforces the importance of the differential diagnosis of lung NETs in order to predict their behavior. Highlights the surgical treatment in TC in which the percentage of advance disease is low. On the other hand, AC and more aggressive tumors, such as LCNEC and SCLC should be treated in a multimodal concept reinforcing the importance of an experienced multidisciplinary team.

      Clinical trial identification:


      Legal entity responsible for the study:
      N/A

      Funding:
      Has not received any funding

      Disclosure:
      All authors have declared no conflicts of interest.

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