A research team from City of Hope Medical Center in Duarte, California led by Dr. Dan J Raz, MD, an Assistant Professor in the Division of Thoracic Surgery and Co-director of the Lung Cancer and Thoracic Oncology Program, recently released data from their study that compared the survival outcomes for patients with lung carcinoid tumors by the treatment method chosen: surgical or non-surgical.  The study, entitled, “Natural History of Typical Pulmonary Carcinoid Tumors,” was published in the latest edition of CHEST Journal.

About Lung Carcinoid Tumors:

Lung carcinoid tumors (also known as lung carcinoids) are a rare type of lung cancer found most often in Caucasian females.  This type of lung cancer grows slower and is made up of a special type of hormonal cell called the neuroendocrine cell.

There are two types of lung carcinoid tumors:

• Typical carcinoids: these account for 9 out of the 10 diagnosed carcinoids and they grow slowly and rarely metastasize
• Atypical carcinoids: these are very rare, but grow much faster and have a greater capacity for metastasis than typical carcinoids.

There are numerous surgical options available for patients diagnosed with lung carcinoid tumors, including:

• Sleeve resection: removes sections of the airway above and below the tumor along with the tumor. The sections of the airway are then reconnected, similar to sewing the sections of a sleeve together after part of it has been cut off.
• Sublobar resection: most often the tumor is small and this procedure may be performed to remove a small, wedge-shaped portion of the lung.
• Lobectomy: involves the removal of a portion of the lung called a lobe.
• Pneumonectomy: involves removal of the entire lung.
• Lymph node dissection: lymph nodes near the lungs are removed during the above surgeries to determine if metastasis has occurred.

About The Study:

Dr. Raz and his team utilized patient data from the Surveillance, Epidemiology, and End Results Program. They identified 4,111 patients with biopsy specimen-proven lymph node-negative typical carcinoid tumor of the lung between 1988 and 2010, with the following treatment classification:

• 306 had no resection.
• 929 underwent sublobar resection.
• 2,876 underwent lobectomy.

The researchers looked at the overall predictors of survival for these patients by treatment classification and found the following:

• The overall survival rate after 5 years was 93% for patients undergoing lobectomy.
• The overall survival rate after 5 years was 92% for patients undergoing sub lobar resection.
• The overall survival rate after 5 years was 69% for patients who declined a surgical option.
• An increase in patient age was associated with disease-specific mortality in which patients who were 80 years and older were more likely to die when compared with patients aged 18 to 49 years.

Why These Results Are Important:

These results show that for this patient population, choosing a surgical method to treat lymph node-negative carcinoid tumors is associated with a greater 5-year survival rate in comparison to a nonoperative treatment method.

When discussing these important findings the researchers stated, “We emphasize that patients who are fit for surgery should still undergo resection, Although there was selection bias in the assignment of treatment in this study, the data demonstrate a survival benefit to resection…and these results could provide important information for counseling patients on the possible outcomes of having or not having surgery.”

About City of Hope

City of Hope is a leading research and treatment center for cancer, diabetes and other life-threatening diseases. Designated as a comprehensive cancer center, the highest recognition bestowed by the National Cancer Institute, City of Hope is also a founding member of the National Comprehensive Cancer Network, with research and treatment protocols that advance care throughout the nation. City of Hope’s main hospital is located in Duarte, California, just northeast of Los Angeles, with community clinics in southern California.