title: Pulmonary carcinoid tumours: indolent but not benign.
abstract: BACKGROUND
  The aim of this retrospective study was to analyse the malignant behaviour of low-grade pulmonary neuroendocrine tumours (NETs) treated at our institution.
  
  
  METHODS
  We reviewed 48 consecutive patients with pulmonary NETs referred to our Medical Oncology Unit between 1998 and 2006, including 33 subjects with typical carcinoids (TCs) and 15 with atypical carcinoids (ACs).
  
  
  RESULTS
  At diagnosis, there were 37 metastatic and 11 non-metastatic patients. Medical treatments used were somatostatin analogues, combined chemotherapy, within study protocols, 5-fluorouracil/dacarbazine/epiadriamycin (FDE), and oxaliplatin plus capecitabine (XELOX). Median disease-free survival was 72 months for the TC patients and 38 months for the AC patients. Actuarial 5-year survival was 93% for those with TCs and 73% for those with ACs. The mean overall survival was 68 months for the non-metastatic patients (78 months for TC patients and 58 months for AC patients) and 36 months for patients with advanced disease (42 and 32 months, respectively).
  
  
  CONCLUSIONS
  Cell type is the strongest determinant of prognosis, and the degree of malignancy increases from TCs to ACs. Moreover, the prognosis of metastatic pulmonary carcinoids is not as good as expected. Our analysis suggests that patients with advanced disease should receive first-line therapy with a somatostatin analogue, with chemotherapy regimens (FDE, XELOX) used in progressing cases.
authors.affiliation: Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: De Dosso
authors.forename: Emilio
authors.initials: E
authors.lastname: Bajetta
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Procopio
authors.forename: Diego
authors.initials: D
authors.lastname: Cortinovis
authors.forename: Roberto
authors.initials: R
authors.lastname: Buzzoni
authors.forename: Laura
authors.initials: L
authors.lastname: Catena
authors.forename: Marco
authors.initials: M
authors.lastname: Platania
authors.forename: Elena
authors.initials: E
authors.lastname: Verzoni
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002276:Carcinoid Tumor / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate