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Role of Adjuvant Chemotherapy in Pulmonary Carcinoids: An NCDB Analysis. | LitMetric

Role of Adjuvant Chemotherapy in Pulmonary Carcinoids: An NCDB Analysis.

Anticancer Res

Division of Hematology & Oncology, Roswell Park Comprehensive Cancer Center, University at Buffalo School of Medicine, Buffalo, NY, U.S.A.

Published: December 2019

AI Article Synopsis

  • Typical carcinoids (TC) and atypical carcinoids (AC) are rare types of lung cancer, making their treatment complex due to lack of randomized studies and conflicting guidelines.
  • A study analyzed 6,673 cases from the National Cancer Database between 2004-2014 to assess the effectiveness of adjuvant chemotherapy after surgery.
  • Findings indicated that TC patients generally do well with surgery alone, while stage III AC patients may benefit from chemotherapy, though results were not statistically significant.

Article Abstract

Background/aim: Typical carcinoids (TC) and atypical carcinoids (AC) are rare diseases. A paucity of randomized studies and disagreements among various guidelines makes the management challenging.

Patients And Methods: Using codes for TC (8240) and AC (8249) in the National Cancer Database (NCDB), all surgically resected cases from 2004-2014 were included to evaluate the need for adjuvant chemotherapy.

Results: A total of 6,673 cases were included, 88% were TCs and 12% were ACs. From 2004 to 2014, the proportion of TCs went up from 1.3% to 1.8% and ACs from 0.1% to 0.3% of all lung malignancies. TC patients did well with surgery alone in all stages. AC patients with stage I [5-year overall survival (OS) - 84% vs. 52%; S vs. S+CT] and stage II disease (5-year OS - 81% vs. 55%; S vs. S+CT) showed better OS trend with surgery alone, while stage III patients showed some benefit with the use of adjuvant chemotherapy (5-year OS - 46% vs. 54%; S vs. S+CT). These results supported the National Comprehensive Cancer Network (NCCN) guidelines.

Conclusion: No benefit was seen from adjuvant chemotherapy in TCs. While the adjuvant therapy may add benefit in stage III AC, the numbers are small and did not reach statistical significance.

Download full-text PDF

Source
http://dx.doi.org/10.21873/anticanres.13900DOI Listing

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