The role of adjuvant therapy for atypical bronchopulmonary carcinoids.
Lung Cancer
; 131: 90-94, 2019 05.
Article
in En
| MEDLINE
| ID: mdl-31027704
ABSTRACT
BACKGROUND:
Atypical bronchopulmonary carcinoid tumors are rare but carry high recurrence rates following resection. The role of adjuvant therapy remains unclear owing to a lack of high-volume data. To address this knowledge gap, we examined predictors of adjuvant therapy and effects on outcome.METHODS:
We queried the National Cancer Database for patients with resected stage I-III atypical carcinoid. Adjuvant therapy was defined as chest radiation, chemotherapy, or a combination thereof. Multivariable logistic regression identified predictors of adjuvant therapy. Multivariable Cox regression evaluated predictors of survival. Propensity matching accounted for indication biases.RESULTS:
Overall, 533 stage I/II and 129 stage III patients were identified. Predictors for adjuvant therapy in stage I/II disease were stage II, positive margins, lymph node ratio (LNR) of 1-25%, and more remote year of treatment. Predictors for adjuvant therapy in stage III were female gender and LNR of 26-50%. Median overall survival in stage I/II and III was 116 months and 61 months, respectively. Predictors for survival in stage I/II were age, margins, comorbidity score, and LNR; factors for stage III disease were LNR and more remote year of treatment. Delivery of adjuvant therapy was not independently associated with survival in either stage I/II or III patients. Furthermore, propensity matched analysis did not reveal a benefit to adjuvant therapy.CONCLUSIONS:
This study shows no clear survival benefit with adjuvant radiotherapy and/or chemotherapy, even in stage III disease. Although this implies that adjuvant therapy should not be routinely delivered, individualized judgment is still recommended.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Carcinoid Tumor
/
Chemotherapy, Adjuvant
/
Radiotherapy, Adjuvant
/
Chemoradiotherapy, Adjuvant
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Lung Neoplasms
Type of study:
Prognostic_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
Lung Cancer
Journal subject:
NEOPLASIAS
Year:
2019
Document type:
Article