title: Well-differentiated bronchial neuroendocrine tumors: Clinical management and outcomes in 105 patients.
abstract: BACKGROUND
  Bronchial neuroendocrine tumors (NETs) are rare tumors representing approximately 20%-30% of all neuroendocrine tumors and 2%-3% of all adult lung cancers. Here, they present a large case series of well-differentiated bronchial NETs with the aim of investigating the behavior of these tumors and long-term outcomes.
  
  
  METHODS
  A retrospective review was performed of 105 patients with bronchial NETs managed in a tertiary referral center in the period between January 1998 and January 2012.
  
  
  RESULTS
  Bronchial NETs are commoner in females and the commonest presenting symptoms were cough (13.9%) and dyspnoea (11.6%). OctreoscanTMand Gallium-68 DOTATATE PET were found to have similar diagnostic sensitivity and FDG PET was more sensitive for higher-grade tumors. Over a median follow-up period of 35.5 months mortality rate was 5.7%. The 5-year survival was 76% and the 10-year survival was 62%. Female patients survived longer but this difference was not statistically significant (P = .59). Older age greater than 50 years (P = .027), higher levels of Chromogranin A (CgA) (P = .034), first-line treatment with surgery (P = .005), ki67 over 10% (P = .037), and tumor stage (P = .036) but not tumor grade (P = .22), were significantly associated with survival.
  
  
  CONCLUSIONS
  Several factors have been identified which are independently associated with survival including CgA levels greater than 100 pmol/L, tumor stage, age greater than 50, ki67 over 10% and having surgery as first-line treatment. There was no difference in survival between typical and atypical carcinoids.
authors.affiliation: Neuroendocrine Tumour Unit, European (ENETS) Centre of Excellence, Royal Free Hospital, London, United Kingdom.
authors.forename: Marinos
authors.initials: M
authors.lastname: Pericleous
authors.affiliation: Neuroendocrine Tumour Unit, European (ENETS) Centre of Excellence, Royal Free Hospital, London, United Kingdom.|University College London Cancer Institute, London, United Kingdom.
authors.forename: Anna
authors.initials: A
authors.lastname: Karpathakis
authors.affiliation: Neuroendocrine Tumour Unit, European (ENETS) Centre of Excellence, Royal Free Hospital, London, United Kingdom.
authors.forename: Christos
authors.initials: C
authors.lastname: Toumpanakis
authors.affiliation: Neuroendocrine Tumour Unit, European (ENETS) Centre of Excellence, Royal Free Hospital, London, United Kingdom.
authors.forename: Heather
authors.initials: H
authors.lastname: Lumgair
authors.affiliation: Neuroendocrine Tumour Unit, European (ENETS) Centre of Excellence, Royal Free Hospital, London, United Kingdom.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Reiner
authors.affiliation: Centre of Gastroenterology, Royal Free Hospital, London, United Kingdom.
authors.forename: Laura
authors.initials: L
authors.lastname: Marelli
authors.affiliation: Neuroendocrine Tumour Unit, European (ENETS) Centre of Excellence, Royal Free Hospital, London, United Kingdom.|University College London Cancer Institute, London, United Kingdom.
authors.forename: Christina
authors.initials: C
authors.lastname: Thirlwell
authors.affiliation: Neuroendocrine Tumour Unit, European (ENETS) Centre of Excellence, Royal Free Hospital, London, United Kingdom.
authors.forename: Martyn E
authors.initials: ME
authors.lastname: Caplin
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001984:Bronchial Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D002276:Carcinoid Tumor / Q000473:pathology; D053379:Chromogranin A / Q000032:analysis; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D005500:Follow-Up Studies; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D017063:Outcome Assessment, Health Care; D049268:Positron-Emission Tomography / Q000379:methods; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D000970:Antineoplastic Agents; D053379:Chromogranin A; D019394:Ki-67 Antigen; D019788:Fluorodeoxyglucose F18
keywords: chemotherapy; lung cancer; thoracic surgery; treatment