Lung neuroendocrine tumors: grade and recurrence rate after surgery.
Introduction: Lung neuroendocrine tumors (NETs) are a rare and heterogeneous group of neoplasms. They are classified into low-grade (typical carcinoid), intermedi ate-grade (atypical carcinoid), and high-grade (large-cell and small-cell neuroendocrine carcinoma) tumors. While surgical resection rema...
| Publicado en: | Medicina (Buenos Aires) Vol. 86; no. 3; pp. 720 - 726 |
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| Autores principales: | , , , , , |
| Formato: | Artículo |
| Publicado: |
Medicina (Buenos Aires)
may/jun2026
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| Sumario: | Introduction: Lung neuroendocrine tumors (NETs) are a rare and heterogeneous group of neoplasms. They are classified into low-grade (typical carcinoid), intermedi ate-grade (atypical carcinoid), and high-grade (large-cell and small-cell neuroendocrine carcinoma) tumors. While surgical resection remains the mainstay treatment for many NETs, recurrence rates differ substantially among subtypes. Our primary outcome is to analyze the as sociation between histologic subtype of lung NETs and tumor recurrence. Materials and methods: A comparative retrospective study with a prospective case registry was conducted. All adult patients who underwent surgery due to lung NETs from January 2015 to December 2024 in a high-volume center were included. Demographic, perioperative and histopathological variables were analyzed. Tumor recur rence rate was compared between patients who pre sented with carcinoid tumors and those who presented with large-cell neuroendocrine carcinoma. Results: A total of 57 patients were included (48 with carcinoid tumors and 9 with large-cell neuroendocrine carcinoma). Recurrence occurred in 33.3% of large-cell neuroendocrine carcinoma cases versus 4.1% in the carcinoid group (p 0.02). Large-cell neuroendocrine tu mors also showed significantly larger tumor size (p 0.02), higher Ki-67 index (p 0.001) and more nodal involvement (p 0.04). Conclusion: Lung NETs exhibit distinct recurrence rates based on histologic grade. High-grade tumors present more aggressive features and a higher risk of recurrence. A multidisciplinary approach and strict long-term follow-up are essential, especially in high-grade lung NETs. Introducción: Los tumores neuroendocrinos pulmo nares (TNE) son neoplasias poco frecuentes y hetero géneas, clasificadas en carcinoide típico, carcinoide atípico y carcinoma neuroendocrino de células grandes o pequeñas. Aunque la resección quirúrgica es el trata miento principal, las tasas de recurrencia varían según el subtipo histológico. El objetivo fue analizar la asociación entre el subtipo histológico de los TNE pulmonares y la recurrencia tumoral. Materiales y métodos: Se realizó un estudio retros pectivo comparativo basado en un registro prospectivo de pacientes adultos sometidos a resección de TNE pul monar entre enero de 2015 y diciembre de 2024 en un centro de alto volumen. Se analizaron variables demo gráficas, perioperatorias e histopatológicas, y se compa raron las tasas de recurrencia entre tumores carcinoides y carcinoma neuroendocrino de células grandes. Resultados: Se incluyeron 57 pacientes 48 con tumo res carcinoides y 9 con carcinoma neuroendocrino de células grandes. La recurrencia se observó en el 33.3 % de los casos con carcinoma neuroendocrino de células grandes frente al 4.1 % en los tumores carcinoides (p = 0.02). Los tumores de células grandes presentaron mayor tamaño tumoral (p = 0.02), índice Ki-67 más alto (p = 0.001) y mayor afectación ganglionar (p = 0.04). Conclusión: Los TNE pulmonares muestran un com portamiento distinto según el grado histológico. Los tumores de alto grado exhiben características más agre sivas y mayor riesgo de recurrencia. Un enfoque multi disciplinario y un seguimiento prolongado son esencia les, especialmente en los TNE pulmonares de alto grado. |
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