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Pulmonary carcinoid tumours: incidence, histology, and surgical outcome. A population-based study

  • Astridur Petursdottir
  • Johanna Sigurdardottir
  • Bjorn M. Fridriksson
  • Arni Johnsen
  • Helgi J. Isaksson
  • Hronn Hardardottir
  • Steinn Jonsson
  • Tomas GudbjartssonEmail author
Original Article
  • 40 Downloads

Abstract

Background

Pulmonary carcinoids (PCs) represent only a minority of all primary pulmonary malignancies but they are the most common type of pulmonary malignancy diagnosed in children and adolescents. In this nationwide study, we analyzed data on all PC tumours in the Icelandic population over a 60-year period and concentrated especially on incidence and patient outcomes.

Methods

We studied all cases of PCs diagnosed in Iceland in the period 1955‒2015. Histological specimens were re-evaluated and the tumours were staged according to the TNM system (seventh edition). Survival was estimated using the Kaplan–Meier method, with a mean follow-up of 15.7 years.

Results

Altogether, 88 patients (median age 51.0 years, 65.9% women) were diagnosed with PCs in the study period. The incidence increased from 0.19/100,000/year in the first decade (1955‒1964) to 0.58/100,000/year in the last decade (2005‒2015), with a mean increase of 29.0% per decade of the study period (p < 0.001). The rise in incidental detection was, however, not significant. The median tumour diameter was 2.2 cm (range 0.4‒7.0) and typical histology was seen in 74 patients (84.1%). The other 14 patients (15.9%) had atypical histology. In all, 90.9% of the patients underwent pulmonary resection, 81.2% of them with lobectomy, with all of them surviving at least 30 days postoperatively. Most patients (n = 52, 62.7%) were stage IA at diagnosis, 15 (18.1%) were stage IB, nine (10.8%) were stage IIA, and three were stage IIIA (3.6%). Four patients (4.8%) had distant metastases (stage IV), two of whom had typical histology. Five-year survival was 89.8% for all patients: 93.2% for patients with typical histology and 70.7% for those with atypical histology.

Conclusion

The incidence of PCs in Iceland has increased significantly over the last six decades, which cannot be explained by a rise in incidental detection at chest imaging. Most patients have localized disease and a favourable histology, where the long-term outcome is excellent.

Keywords

Carcinoid tumour Pulmonary Incidence Survival Histology Nationwide 

Notes

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Copyright information

© The Japanese Association for Thoracic Surgery 2019

Authors and Affiliations

  • Astridur Petursdottir
    • 1
  • Johanna Sigurdardottir
    • 4
  • Bjorn M. Fridriksson
    • 1
  • Arni Johnsen
    • 5
  • Helgi J. Isaksson
    • 3
  • Hronn Hardardottir
    • 2
  • Steinn Jonsson
    • 2
    • 5
  • Tomas Gudbjartsson
    • 1
    • 5
    Email author
  1. 1.Department of Cardiothoracic SurgeryLandspitali University HospitalReykjavikIceland
  2. 2.Department of PulmonologyLandspitali University HospitalReykjavikIceland
  3. 3.Department of PathologyLandspitali University HospitalReykjavikIceland
  4. 4.Department of SurgeryVasteras County HospitalReykjavikIceland
  5. 5.Faculty of MedicineUniversity of IcelandReykjavikIceland

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