eMedicine Specialties > Thoracic Surgery > Tumors

Carcinoid Lung Tumors: Follow-up

Author: Mary C Mancini, MD, PhD, Professor, Department of Surgery, Louisiana State University Health Sciences Center
Contributor Information and Disclosures

Updated: Oct 23, 2008

Outcome and Prognosis

Carcinoid tumors of the lung generally have a better prognosis than other forms of pulmonary malignancy. They possess an overall 5-year survival rate of 78-95% and a 10-year survival rate of 77-90%.

Typical carcinoid tumors have been found to have a much better prognosis than do the atypical variety. Atypical carcinoid tumors have been associated with a 5-year survival rate of 40-60% and a 10-year survival rate of 31-60%, depending on the series.

Regardless of the histologic type, the presence of lymph node metastases at the time of resection has a significant effect on prognosis in many series, producing 5-year survival rates of 37-80% and 10-year rates of 22-80%. This wide variation in survival rates is likely related to the percent of atypical carcinoid tumors present in each analyzed series.

The presence of tumorlets associated with the primary tumor appears to worsen the prognosis.

Whether or not tumor size is a prognostic risk factor is uncertain.

The presence of carcinoid syndrome or other paraneoplastic syndromes in the absence of lymph node or distant metastases does not seem to affect prognosis adversely.14,16,17,18,19

Future and Controversies

The exact determination of the specific histologic entities within the spectrum of pulmonary neuroendocrine tumors is an area of considerable controversy. Several authors have renamed the entire spectrum of pulmonary neuroendocrine neoplasms based on more advanced histologic study. One classification system labels typical carcinoid tumors as type 1 Kulchitsky cell carcinoma, atypical carcinoids as type 2 Kulchitsky cell carcinomas, and small cell carcinoma as type 3. Another defines these as well-differentiated, intermediate cell, and small cell neuroendocrine carcinomas.

Additional changes in tumor classification also have been proposed specifically regarding atypical carcinoid tumors. Recently, a number of subcategories of atypical carcinoid have been described based upon the identification of genetic molecular abnormalities. The addition of genetic marker identification to previous methods of tumor analysis has resulted in further subclassification for some of the more aggressive types of these neuroendocrine tumors. Large cell neuroendocrine and mixed small-large cell neuroendocrine carcinomas have been proposed as high-grade tumors more closely related to small cell carcinoma than to carcinoids, falling into the disease spectrum between atypical carcinoid and small cell carcinoma.

 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Jane M Eggerstedt, MD, to the development and writing of this article.



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References
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Further Reading

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Keywords

carcinoid lung tumor, bronchial adenomas, typical carcinoids, atypical carcinoids, neuroendocrine lung tumors, pulmonary neoplasms, bronchopulmonary carcinoid tumors, carcinoid syndrome, lung cancer, intrabronchial mass

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Contributor Information and Disclosures

Author

Mary C Mancini, MD, PhD, Professor, Department of Surgery, Louisiana State University Health Sciences Center
Mary C Mancini, MD, PhD is a member of the following medical societies: American Heart Association, American Medical Association, American Thoracic Society, Association for Academic Surgery, Association for Surgical Education, International College of Surgeons, International Society for Heart and Lung Transplantation, New York Academy of Sciences, Phi Beta Kappa, and Southern Thoracic Surgical Association
Disclosure: Nothing to disclose.

Medical Editor

Jeffrey C Milliken, MD, Chief, Division of Cardiothoracic Surgery, University of California at Irvine Medical Center; Clinical Professor, Department of Surgery, University of California at Irvine School of Medicine
Jeffrey C Milliken, MD is a member of the following medical societies: Alpha Omega Alpha, American Association for Thoracic Surgery, American College of Cardiology, American College of Chest Physicians, American College of Surgeons, American Heart Association, American Society for Artificial Internal Organs, California Medical Association, International Society for Heart and Lung Transplantation, Phi Beta Kappa, Society of Thoracic Surgeons, Southwest Oncology Group, and Western Surgical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Shreekanth V Karwande, MBBS, Chair, Professor, Department of Surgery, Division of Cardiothoracic Surgery, University of Utah School of Medicine and Medical Center
Shreekanth V Karwande, MBBS is a member of the following medical societies: American Association for Thoracic Surgery, American College of Chest Physicians, American College of Surgeons, American Heart Association, Society of Critical Care Medicine, Society of Thoracic Surgeons, and Western Thoracic Surgical Association
Disclosure: Nothing to disclose.

CME Editor

Rajalaxmi McKenna, MD, FACP, Consulting Staff, Department of Medicine, Southwest Medical Consultants, SC, Good Samaritan Hospital, Advocate Health Systems
Rajalaxmi McKenna, MD, FACP is a member of the following medical societies: American Society of Clinical Oncology, American Society of Hematology, and International Society on Thrombosis and Haemostasis
Disclosure: Nothing to disclose.

Chief Editor

John Geibel, MD, DSc, MA, Vice Chairman, Professor, Department of Surgery, Section of Gastrointestinal Medicine and Department of Cellular and Molecular Physiology, Yale University School of Medicine; Director of Surgical Research, Department of Surgery, Yale-New Haven Hospital
John Geibel, MD, DSc, MA is a member of the following medical societies: American Gastroenterological Association, American Physiological Society, American Society of Nephrology, Association for Academic Surgery, International Society of Nephrology, New York Academy of Sciences, and Society for Surgery of the Alimentary Tract
Disclosure: AMGEN Royalty Other; AstraZeneca Grant/research funds Other

 
 
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