Survival of carcinoid lung neuroendocrine tumours after surgical resection: A retrospective audit of 633 cases over 26 years
Mohamed Mortagy, Ker Shiong Tan, Marie Line El Asmar, Daisuke Nonaka, Saoirse Dolly, Rajaventhan Srirajaskanthan, Dominique Clement, Andrea Bille, Juliet King, Akshay Patel, John RamageBackground:
Optimal postoperative follow-up for lung neuroendocrine tumours (L-NET) and surgical resection approaches remain debated. This audit aimed to benchmark long-term outcomes after L-NET surgery at a high-volume centre, identify prognostic factors, and estimate follow-up duration.
Methods:
This was a retrospective audit of 633 L-NET resections at a high-volume centre (1997–2023). Kaplan-Meier plots for overall survival (OS) were generated. Cox regression was used to identify the factors affecting OS. Expected survival was generated by matching age, sex, and year of surgery to national life tables.
Results:
Median age was 63 years; 66.8% were female; 78.2% had typical morphology; 78.2% were stage 1; and lobectomy predominated (83.7%). Ten-year OS was 80.4% for all cases and 82.7%, 84.5%, 58.9%, and 67.0% for lobectomy, pneumonectomy, segmentectomy, and wedge resection, respectively. Actual OS overlapped at ~220 months for all cases. Multivariable analysis showed that worse all-cause mortality was associated with advanced age (aHR 1.08) and lymphovascular invasion (aHR 2.38), but not procedure type.
Conclusions:
This audit provides valuable insights into the benefits and risks of surgery for L-NET at our centre. It identifies risk factors for increased all-cause mortality. It provides data on follow-up, which can inform local case selection, guidelines and policies at our centre.