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Title: Atypical carcinoid tumours of the lung: Prognostic factors and patterns of recurrence
Authors: Cañizares, Miguel A.
Matilla, J. M.
Cueto, A.
Algar, J.
Muguruza, I.
Moreno-Mata, N.
Moreno-Balsalobre, R.
Guijarro, R.
Arrabal, R.
Garcia-Fontan, E.
Gonzalez-Pinẽiro, A.
Garcia-Yuste, M.
Matilla, Jose Maria
Heras, Felix
Borrego, Henar
Escobar, Ignacio
Moya, Joan
Lago, Juan
Saldaña, David
Garrido, Pilar
Cerezo, Francisco
Gonzalez-Aragoneses, Federico
Simon, Carlos
Alvarez, Emilio
Cebollero, Maria
Rodriguez-Paniagua, Jose Manuel
Arnau, Antonio
Lopez-Rivero, Luis
Quevedo, Santiago
Camacho, Maria Carmen
Astudillo, Julio
Perez, Javier
Molins, Laureano
Mier, Jose Manuel
Sanchez-Palencia, Abel
Concha, Angel
Freixinet, Jorge 
Rodriguez, Pedro
Romero, Teresa
Torres, Juan
Bermejo, Juan
Moreno, Nicolas
Blanco, Ana
Borro, Jose Maria
De-la-Torre, Mercedes
Capdevilla, Ana
Moreno, Ramon
Serra, Mireia
Rami-Porta, Ramon
Benitez, Antonio
Varela, Andres
Cordoba, Mar
Blanco-Ramos, Montserrat
Zapatero, José
Rivas, Juan Jose
Menal, Patricia
Galan, Genaro
Ansotegui, Emilio
UNESCO Clasification: 32 Ciencias médicas
320713 Oncología
Keywords: Carcinoid tumours
Issue Date: 2014
Journal: Thorax 
Abstract: Background Atypical carcinoids (AC) of the lung are rare intermediate-grade neuroendocrine neoplasms. Prognostic factors for these tumours are undefined. Methods Our cooperative group retrieved data on 127 patients operated between 1980 and 2009 because of an AC. Several clinical and pathological features were studied. Results In a univariable analysis, T-status (p=0.005), N-status (p=0.021), preoperative M-status (previously treated) (p=0.04), and distant recurrence developed during the outcome (p<0.001) presented statistically significant differences related to survival of these patients. In a multivariable analysis, only distant recurrence was demonstrated to be an independent risk factor for survival (p<0.001; HR: 13.1). During the monitoring, 25.2% of the patients presented some kind of recurrence. When we studied recurrence factors in a univariable manner, sublobar resections presented significant relationship with locoregional recurrence (p<0.001). In the case of distant recurrence, T and N status presented significant differences. Patients with preoperative M1 status presented higher frequencies of locoregional and distant recurrence (p=0.004 and p<0.001, respectively). In a multivariable analysis, sublobar resection was an independent prognostic factor to predict locoregional recurrence (p=0.002; HR: 18.1). Conclusions Complete standard surgical resection with radical lymphadenectomy is essential for AC. Sublobar resections are related to locoregional recurrence, so they should be avoided except for carefully selected patients. Nodal status is an important prognostic factor to predict survival and recurrence. Distant recurrence is related to poor outcome.
ISSN: 0040-6376
DOI: 10.1136/thoraxjnl-2013-204102
Source: Thorax[ISSN 0040-6376],v. 69, p. 648-653 (Junio 2014)
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