title: Histology, not lymph node involvement, predicts long-term survival in bronchopulmonary carcinoids.
abstract: Recently, the incidence of bronchopulmonary carcinoid has increased substantially, whereas survival associated with both subtypes has declined. We reviewed our experience with bronchopulmonary carcinoid to identify factors associated with long-term survival. We reviewed our cancer registry  from 1985 to 2009 for all patients undergoing surgical resection for bronchopulmonary carcinoid. Cox regression analysis was used to evaluate prognostic factors. Fifty-two patients met criteria for inclusion. Forty-three patients (82%) presented with typical histology. The likelihood of lymph  node metastasis was similar for patients with typical histology and patients with atypical histology. For patients with typical histology, the 5-year survival rates with and without lymph node metastases were 100 per cent and 97 per cent, respectively (P = 0.420). The overall survival  rate for patients with typical histology (97% at 5 years; 72% at 10 years) was significantly better than for patients with atypical histology (35% at 5 years, 0% at 10 years) (P < 0.001). Univariate and multivariate analyses demonstrated that long-term survival was associated with  histology but not lymph node involvement (hazards ratio = 14.6, 95% confidence interval: 1.7, 125.2). Our data suggests that long-term survival is associated with histology, not lymph node involvement. We found tumor histology to be the strongest predictor of long-term survival in patients  with pulmonary carcinoid tumors.
authors.affiliation: Department of General Surgery, Greenville Hospital System University Medical Center, Greenville, South Carolina 29605, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Johnson
authors.forename: Steven
authors.initials: S
authors.lastname: Trocha
authors.forename: Marc
authors.initials: M
authors.lastname: McLawhorn
authors.forename: Mitchell
authors.initials: M
authors.lastname: Worley
authors.forename: Grace
authors.initials: G
authors.lastname: Wheeler
authors.forename: Laura
authors.initials: L
authors.lastname: Thompson
authors.forename: Nicholas
authors.initials: N
authors.lastname: Schisler
authors.forename: Dave
authors.initials: D
authors.lastname: Schammel
authors.forename: Christine
authors.initials: C
authors.lastname: Schammel
authors.forename: James
authors.initials: J
authors.lastname: Stephenson
authors.forename: William
authors.initials: W
authors.lastname: Bolton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001984:Bronchial Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D002276:Carcinoid Tumor / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011013:Pneumonectomy; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D055815:Young Adult