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Adjuvant Chemotherapy Does Not Confer Superior Survival in Patients With Atypical Carcinoid Tumors.

Publication ,  Journal Article
Anderson, KL; Mulvihill, MS; Speicher, PJ; Yerokun, BA; Gulack, BC; Nussbaum, DP; Harpole, DH; D'Amico, TA; Berry, MF; Hartwig, MG
Published in: Ann Thorac Surg
October 2017

BACKGROUND: Although the use of adjuvant chemotherapy in patients with pathologically node-positive (pN+) atypical carcinoid tumor of the lung is an accepted practice, controversy exists about its use in pathologically node-negative (pN0) patients. Our aim was to determine whether a survival advantage exists in patients receiving chemotherapy postoperatively for pN0 or pN+ atypical carcinoid tumors of the lung. METHODS: Adult patients treated with lobectomy or pneumonectomy for pulmonary atypical carcinoid tumor were identified using the National Cancer Data Base, 2006 to 2011. Propensity scoring (4:1 nearest neighbor algorithm) and survival analysis were used to examine the association between adjuvant chemotherapy and pN+ versus pN0 atypical carcinoid tumors. RESULTS: Of the total 581 patients identified with a diagnosis of atypical carcinoid of the lung, 363 (62.5%) were found to be node negative at the time of operation and 218 (37.5%) had node-positive disease. Adjuvant chemotherapy was used in 15 patients (4.1%) with pN0 disease and 89 patients (40.8%) with pN+ disease. Unadjusted survival, at 12 and 60 months, was similar between pN+ patients who were treated with adjuvant chemotherapy versus patients who received operation alone (adjuvant chemotherapy: 98.9% at 12 months and 47.9% at 60 months versus operation alone: 98.4% and 12 months and 67.1% at 60 months, p = 0.46) and for propensity-matched pN0 (adjuvant chemotherapy: 86.7% at 12 months and 73.3% at 60 months versus operation alone: 87.9% at 12 months and 72.3% at 60 months, p = 0.54). CONCLUSIONS: In a national-level analysis, the use of adjuvant chemotherapy postoperatively in patients with pN+ and pN0 disease conferred no survival advantage; further study is needed to determine proper chemotherapy use for these patients.

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Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

October 2017

Volume

104

Issue

4

Start / End Page

1221 / 1230

Location

Netherlands

Related Subject Headings

  • Survival Analysis
  • Respiratory System
  • Pneumonectomy
  • Middle Aged
  • Male
  • Lymphatic Metastasis
  • Lung Neoplasms
  • Humans
  • Female
  • Chemotherapy, Adjuvant
 

Citation

APA
Chicago
ICMJE
MLA
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Anderson, K. L., Mulvihill, M. S., Speicher, P. J., Yerokun, B. A., Gulack, B. C., Nussbaum, D. P., … Hartwig, M. G. (2017). Adjuvant Chemotherapy Does Not Confer Superior Survival in Patients With Atypical Carcinoid Tumors. Ann Thorac Surg, 104(4), 1221–1230. https://doi.org/10.1016/j.athoracsur.2017.05.011
Anderson, Kevin L., Michael S. Mulvihill, Paul J. Speicher, Babatunde A. Yerokun, Brian C. Gulack, Daniel P. Nussbaum, David H. Harpole, Thomas A. D’Amico, Mark F. Berry, and Matthew G. Hartwig. “Adjuvant Chemotherapy Does Not Confer Superior Survival in Patients With Atypical Carcinoid Tumors.Ann Thorac Surg 104, no. 4 (October 2017): 1221–30. https://doi.org/10.1016/j.athoracsur.2017.05.011.
Anderson KL, Mulvihill MS, Speicher PJ, Yerokun BA, Gulack BC, Nussbaum DP, et al. Adjuvant Chemotherapy Does Not Confer Superior Survival in Patients With Atypical Carcinoid Tumors. Ann Thorac Surg. 2017 Oct;104(4):1221–30.
Anderson, Kevin L., et al. “Adjuvant Chemotherapy Does Not Confer Superior Survival in Patients With Atypical Carcinoid Tumors.Ann Thorac Surg, vol. 104, no. 4, Oct. 2017, pp. 1221–30. Pubmed, doi:10.1016/j.athoracsur.2017.05.011.
Anderson KL, Mulvihill MS, Speicher PJ, Yerokun BA, Gulack BC, Nussbaum DP, Harpole DH, D’Amico TA, Berry MF, Hartwig MG. Adjuvant Chemotherapy Does Not Confer Superior Survival in Patients With Atypical Carcinoid Tumors. Ann Thorac Surg. 2017 Oct;104(4):1221–1230.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

October 2017

Volume

104

Issue

4

Start / End Page

1221 / 1230

Location

Netherlands

Related Subject Headings

  • Survival Analysis
  • Respiratory System
  • Pneumonectomy
  • Middle Aged
  • Male
  • Lymphatic Metastasis
  • Lung Neoplasms
  • Humans
  • Female
  • Chemotherapy, Adjuvant