Journal article
The role of adjuvant therapy for atypical bronchopulmonary carcinoids
Lung cancer (Amsterdam, Netherlands), v 131, pp 90-94
May 2019
PMID: 31027704
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
•Most patients with atypical bronchopulmonary carcinoid were observed post-operatively.•No survival benefit was observed with adjuvant therapy, even in Stage III disease.•Our large US national database analysis supports the omission of adjuvant therapy.
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.
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.
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.
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.
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Details
- Title
- The role of adjuvant therapy for atypical bronchopulmonary carcinoids
- Creators
- Rodney E. Wegner - Allegheny Health NetworkStephen Abel - Allegheny Health NetworkShaakir Hasan - Allegheny Health NetworkZachary D. Horne - Allegheny Health NetworkAthanasios Colonias - Allegheny Health NetworkBenny Weksler - Allegheny Health NetworkVivek Verma - Allegheny Health Network
- Publication Details
- Lung cancer (Amsterdam, Netherlands), v 131, pp 90-94
- Publisher
- Elsevier
- Number of pages
- 5
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000468721500013
- Scopus ID
- 2-s2.0-85063365195
- Other Identifier
- 991021960638504721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Oncology
- Respiratory System