Lobar versus sub-lobar surgery for pulmonary typical carcinoid, a population-based analysis

Muhammad Furqan; Yu-Yu Tien; Mary C Schroeder; Kalpaj R Parekh; John Keech; Bryan G Allen; Alexandra Thomas; Jun Zhang; Gerald Clamon; Taher Abu Hejleh

doi:10.21037/jtd.2018.09.141

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Lobar versus sub-lobar surgery for pulmonary typical carcinoid, a population-based analysis

Journal article

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Lobar versus sub-lobar surgery for pulmonary typical carcinoid, a population-based analysis

Muhammad Furqan, Yu-Yu Tien, Mary C Schroeder, Kalpaj R Parekh, John Keech, Bryan G Allen, Alexandra Thomas, Jun Zhang, Gerald Clamon and Taher Abu Hejleh

Journal of thoracic disease, Vol.10(10), pp.5850-5859

10/2018

DOI: 10.21037/jtd.2018.09.141

PMCID: PMC6236154

PMID: 30505493

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Abstract

The optimal surgery for resectable pulmonary typical carcinoid (TC), e.g., lobar resection (L-R) sub-lobar resection (SL-R), is controversial. This is further explored in this population-based study. The Surveillance, Epidemiology, and End Results (SEER) Program was used to select patients ≥66 years old, and diagnosed between 2000 and 2012 with pulmonary TC. A similar cohort was developed using the SEER-Medicare database (diagnosed from 2000-2007) to identify chemotherapy (CTX) use and co-morbidity. Five-year survival was calculated using univariate and multivariate analysis. A total of 1,506 and 512 patients were identified from SEER and SEER-Medicare, respectively. In the SEER cohort, 49%, 29% and 21% received L-R, SL-R, and no surgery (NS), respectively. Those who received NS were older (P<0.001), had a higher stage (P<0.001), greater comorbidity (P<0.001), and were more likely to receive radiotherapy (XRT) (P<0.001) and CTX (P<0.001). Relative survival was nearly 100% for those who received L-R or SL-R as opposed to 72% for those who received NS (P<0.001). Cox models showed no survival difference for L-R SL-R (HR 1.1, P=0.663), but worse survival for those who received NS L-R or SL-R (HR 3.6, P<0.001). XRT in NS cohort was associated with increased risk of death (HR 2.3, P=0.017). SL-R was better than NS, and similar to L-R in terms of survival. SL-R should be considered over NS if L-R is unfeasible. Role of adjuvant CTX and XRT is unclear as these did not improve survival in this study.

lung cancer

radiotherapy (XRT)

chemotherapy (CTX)

neuroendocrine tumor (NE tumor)

Carcinoid tumor

Details

Title: Subtitle: Lobar versus sub-lobar surgery for pulmonary typical carcinoid, a population-based analysis
Creators: Muhammad Furqan - Division of Hematology, Oncology, Blood & Marrow Transplantation, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Yu-Yu Tien - Program in Pharmaceutical Socioeconomics, Department of Pharmacy Practice and Science, College of Pharmacy, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
Mary C Schroeder - Division of Health Services Research, Department of Pharmacy Practice and Science, College of Pharmacy, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
Kalpaj R Parekh - Division of Cardiothoracic Surgery, Department of Surgery, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
John Keech - Division of Cardiothoracic Surgery, Department of Surgery, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
Bryan G Allen - Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Alexandra Thomas - Wake Forest Baptist Medical Center, Medical Center Blvd., Winston-Salem, NC, USA
Jun Zhang - Division of Hematology, Oncology, Blood & Marrow Transplantation, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Gerald Clamon - Division of Hematology, Oncology, Blood & Marrow Transplantation, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Taher Abu Hejleh - Department of Internal Medicine, Division of Hematology, Oncology, and Blood & Marrow Transplantation, King Hussein Cancer Center, Amman, Jordan
Resource Type: Journal article
Publication Details: Journal of thoracic disease, Vol.10(10), pp.5850-5859
DOI: 10.21037/jtd.2018.09.141
PMID: 30505493
PMCID: PMC6236154
NLM abbreviation: J Thorac Dis
ISSN: 2072-1439
eISSN: 2077-6624
Publisher: China
Grant note: P01 CA217797 / NCI NIH HHS P30 DK054759 / NIDDK NIH HHS P30 CA086862 / NCI NIH HHS
Language: English
Date published: 10/2018
Academic Unit: Anatomy and Cell Biology; Hematology, Oncology, and Blood & Marrow Transplantation; Surgery; Radiation Oncology; Pharmacy Practice and Science; Cardiothoracic Surgery; Internal Medicine
Record Identifier: 9984047797502771

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