TY - JOUR
T1 - Prognostic significance of laterality in lung neuroendocrine tumors
AU - La Salvia, Anna
AU - Persano, Irene
AU - Siciliani, Alessandra
AU - Verrico, Monica
AU - Bassi, Massimiliano
AU - Modica, Roberta
AU - Audisio, Alessandro
AU - Zanata, Isabella
AU - Trabalza Marinucci, Beatrice
AU - Trevisi, Elena
AU - Puliani, Giulia
AU - Rinzivillo, Maria
AU - Parlagreco, Elena
AU - Baldelli, Roberto
AU - Feola, Tiziana
AU - Sesti, Franz
AU - Razzore, Paola
AU - Mazzilli, Rossella
AU - Mancini, Massimiliano
AU - Panzuto, Francesco
AU - Volante, Marco
AU - Giannetta, Elisa
AU - Romero, Carmen
AU - Appetecchia, Marialuisa
AU - Isidori, Andrea
AU - Venuta, Federico
AU - Ambrosio, Maria Rosaria
AU - Zatelli, Maria Chiara
AU - Ibrahim, Mohsen
AU - Colao, Annamaria
AU - Brizzi, Maria Pia
AU - García-Carbonero, Rocío
AU - Faggiano, Antongiulio
N1 - Publisher Copyright:
© 2022, The Author(s).
PY - 2022/6
Y1 - 2022/6
N2 - Purpose:: Well-differentiated lung neuroendocrine tumors (Lu-NET) are classified as typical (TC) and atypical (AC) carcinoids, based on mitotic counts and necrosis. However, prognostic factors, other than tumor node metastasis (TNM) stage and the histopathological diagnosis, are still lacking. The current study is aimed to identify potential prognostic factors to better stratify lung NET, thus, improving patients’ treatment strategy and follow-up. Methods:: A multicentric retrospective study, including 300 Lung NET, all surgically removed, from Italian and Spanish Institutions. Results:: Median age 61 years (13–86), 37.7% were males, 25.0% were AC, 42.0% were located in the lung left parenchyma, 80.3% presented a TNM stage I-II. Mitotic count was ≥2 per 10 high-power field (HPF) in 24.7%, necrosis in 13.0%. Median overall survival (OS) was 46.1 months (0.6–323), median progression-free survival (PFS) was 36.0 months (0.3–323). Female sex correlated with a more indolent disease (T1; N0; lower Ki67; lower mitotic count and the absence of necrosis). Left-sided primary tumors were associated with higher mitotic count and necrosis. At Cox-multivariate regression model, age, left-sided tumors, nodal (N) positive status and the diagnosis of AC resulted independent negative prognostic factors for PFS and OS. Conclusions:: This study highlights that laterality is an independent prognostic factors in Lu-NETs, with left tumors being less frequent but showing a worse prognosis than right ones. A wider spectrum of clinical and pathological prognostic factors, including TNM stage, age and laterality is suggested. These parameters could help clinicians to personalize the management of Lu-NET.
AB - Purpose:: Well-differentiated lung neuroendocrine tumors (Lu-NET) are classified as typical (TC) and atypical (AC) carcinoids, based on mitotic counts and necrosis. However, prognostic factors, other than tumor node metastasis (TNM) stage and the histopathological diagnosis, are still lacking. The current study is aimed to identify potential prognostic factors to better stratify lung NET, thus, improving patients’ treatment strategy and follow-up. Methods:: A multicentric retrospective study, including 300 Lung NET, all surgically removed, from Italian and Spanish Institutions. Results:: Median age 61 years (13–86), 37.7% were males, 25.0% were AC, 42.0% were located in the lung left parenchyma, 80.3% presented a TNM stage I-II. Mitotic count was ≥2 per 10 high-power field (HPF) in 24.7%, necrosis in 13.0%. Median overall survival (OS) was 46.1 months (0.6–323), median progression-free survival (PFS) was 36.0 months (0.3–323). Female sex correlated with a more indolent disease (T1; N0; lower Ki67; lower mitotic count and the absence of necrosis). Left-sided primary tumors were associated with higher mitotic count and necrosis. At Cox-multivariate regression model, age, left-sided tumors, nodal (N) positive status and the diagnosis of AC resulted independent negative prognostic factors for PFS and OS. Conclusions:: This study highlights that laterality is an independent prognostic factors in Lu-NETs, with left tumors being less frequent but showing a worse prognosis than right ones. A wider spectrum of clinical and pathological prognostic factors, including TNM stage, age and laterality is suggested. These parameters could help clinicians to personalize the management of Lu-NET.
KW - Ki67 index
KW - Lung neuroendocrine tumors
KW - Mitotic count
KW - Necrosis
KW - Prognostic factors
KW - Tumor location
UR - http://www.scopus.com/inward/record.url?scp=85126363287&partnerID=8YFLogxK
U2 - 10.1007/s12020-022-03015-w
DO - 10.1007/s12020-022-03015-w
M3 - Article
C2 - 35301675
AN - SCOPUS:85126363287
SN - 1355-008X
VL - 76
SP - 733
EP - 746
JO - Endocrine
JF - Endocrine
IS - 3
ER -