Prognostic model of survival for typical bronchial carcinoid tumours: Analysis of 1109 patients on behalf of the European Association of Thoracic Surgeons (ESTS) Neuroendocrine Tumours Working Group

Pier Luigi Filosso, Francesco Guerrera, Andrea Evangelista, Stefan Welter, Pascal Thomas, Paula Moreno Casado, Erino Angelo Rendina, Federico Venuta, Luca Ampollini, Alessandro Brunelli, Franco Stella, Mario Nosotti, Federico Raveglia, Valentina Larocca, Ottavio Rena, Stefano Margaritora, Francesco Ardissone, William D. Travis, Inderpal Sarkaria, Dariusz SaganMariano Garcia Yuste, Eric Lim, Konstantinos Papagiannopoulos, Hisao Asamura

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

OBJECTIVES: Typical carcinoids (TCs) are uncommon, slow-growing neoplasms, usually with high 5-year survival rates. As these are rare tumours, their management is still based on small clinical observations and no international guidelines exist. Based on the European Society of Thoracic Surgeon Neuroendocrine TumoursWorking Group (NET-WG) Database, we evaluated factors that may influence TCs mortality. METHODS: Using the NET-WG database, an analysis on TC survival was performed. Overall survival (OS) was calculated starting from the date of intervention. Predictors of OS were investigated using the Cox model with shared frailty (accounting for the within-centre correlation). Candidate predictors were: gender, age, smoking habit, tumour location, previous malignancy, Eastern Cooperative Oncology Group (ECOG) performance status (PS), pT, pN, TNM stage and tumour vascular invasion. The final model included predictors with P = 0.15 after a backward selection. Missing data in the evaluated predictors were multiple-imputed and combined estimates were obtained from five imputed data sets. RESULTS: For 58 of 1167 TC patients vital status was unavailable and analyses were therefore performed on 1109 patients from 17 institutions worldwide. During a median follow-up of 50 months, 87 patients died, with a 5-year OS rate of 93.7% (95% confidence interval: 91.7-95.3). Backward selection resulted in a prediction model for mortality containing age, gender, previous malignancies, peripheral tumour, TNM stage and ECOG PS. The final model showed a good discrimination ability with a C-statistic equal to 0.836 (bootstrap optimism-corrected 0.806). CONCLUSIONS: We presented and validated a promising prognostic model for TC survival, showing good calibration and discrimination ability. Further analyses are needed and could be focused on an external validation of this model.

Original languageEnglish
Pages (from-to)441-447
Number of pages7
JournalEuropean Journal of Cardio-thoracic Surgery
Volume48
Issue number3
DOIs
Publication statusPublished - 2015

Fingerprint

Neuroendocrine Tumors
Carcinoid Tumor
Thorax
Survival
Neoplasms
Aptitude
Survival Rate
Databases
Mortality
Surgeons
Proportional Hazards Models
Calibration
Habits
Blood Vessels
Smoking
Guidelines
Confidence Intervals

Keywords

  • Lung
  • Metastases
  • Neuroendocrine tumours
  • Prognostic score
  • Recurrence
  • Surgery
  • Survival
  • Typical carcinoid

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Prognostic model of survival for typical bronchial carcinoid tumours : Analysis of 1109 patients on behalf of the European Association of Thoracic Surgeons (ESTS) Neuroendocrine Tumours Working Group. / Filosso, Pier Luigi; Guerrera, Francesco; Evangelista, Andrea; Welter, Stefan; Thomas, Pascal; Casado, Paula Moreno; Rendina, Erino Angelo; Venuta, Federico; Ampollini, Luca; Brunelli, Alessandro; Stella, Franco; Nosotti, Mario; Raveglia, Federico; Larocca, Valentina; Rena, Ottavio; Margaritora, Stefano; Ardissone, Francesco; Travis, William D.; Sarkaria, Inderpal; Sagan, Dariusz; Yuste, Mariano Garcia; Lim, Eric; Papagiannopoulos, Konstantinos; Asamura, Hisao.

In: European Journal of Cardio-thoracic Surgery, Vol. 48, No. 3, 2015, p. 441-447.

Research output: Contribution to journalArticle

Filosso, PL, Guerrera, F, Evangelista, A, Welter, S, Thomas, P, Casado, PM, Rendina, EA, Venuta, F, Ampollini, L, Brunelli, A, Stella, F, Nosotti, M, Raveglia, F, Larocca, V, Rena, O, Margaritora, S, Ardissone, F, Travis, WD, Sarkaria, I, Sagan, D, Yuste, MG, Lim, E, Papagiannopoulos, K & Asamura, H 2015, 'Prognostic model of survival for typical bronchial carcinoid tumours: Analysis of 1109 patients on behalf of the European Association of Thoracic Surgeons (ESTS) Neuroendocrine Tumours Working Group', European Journal of Cardio-thoracic Surgery, vol. 48, no. 3, pp. 441-447. https://doi.org/10.1093/ejcts/ezu495
Filosso, Pier Luigi ; Guerrera, Francesco ; Evangelista, Andrea ; Welter, Stefan ; Thomas, Pascal ; Casado, Paula Moreno ; Rendina, Erino Angelo ; Venuta, Federico ; Ampollini, Luca ; Brunelli, Alessandro ; Stella, Franco ; Nosotti, Mario ; Raveglia, Federico ; Larocca, Valentina ; Rena, Ottavio ; Margaritora, Stefano ; Ardissone, Francesco ; Travis, William D. ; Sarkaria, Inderpal ; Sagan, Dariusz ; Yuste, Mariano Garcia ; Lim, Eric ; Papagiannopoulos, Konstantinos ; Asamura, Hisao. / Prognostic model of survival for typical bronchial carcinoid tumours : Analysis of 1109 patients on behalf of the European Association of Thoracic Surgeons (ESTS) Neuroendocrine Tumours Working Group. In: European Journal of Cardio-thoracic Surgery. 2015 ; Vol. 48, No. 3. pp. 441-447.
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abstract = "OBJECTIVES: Typical carcinoids (TCs) are uncommon, slow-growing neoplasms, usually with high 5-year survival rates. As these are rare tumours, their management is still based on small clinical observations and no international guidelines exist. Based on the European Society of Thoracic Surgeon Neuroendocrine TumoursWorking Group (NET-WG) Database, we evaluated factors that may influence TCs mortality. METHODS: Using the NET-WG database, an analysis on TC survival was performed. Overall survival (OS) was calculated starting from the date of intervention. Predictors of OS were investigated using the Cox model with shared frailty (accounting for the within-centre correlation). Candidate predictors were: gender, age, smoking habit, tumour location, previous malignancy, Eastern Cooperative Oncology Group (ECOG) performance status (PS), pT, pN, TNM stage and tumour vascular invasion. The final model included predictors with P = 0.15 after a backward selection. Missing data in the evaluated predictors were multiple-imputed and combined estimates were obtained from five imputed data sets. RESULTS: For 58 of 1167 TC patients vital status was unavailable and analyses were therefore performed on 1109 patients from 17 institutions worldwide. During a median follow-up of 50 months, 87 patients died, with a 5-year OS rate of 93.7{\%} (95{\%} confidence interval: 91.7-95.3). Backward selection resulted in a prediction model for mortality containing age, gender, previous malignancies, peripheral tumour, TNM stage and ECOG PS. The final model showed a good discrimination ability with a C-statistic equal to 0.836 (bootstrap optimism-corrected 0.806). CONCLUSIONS: We presented and validated a promising prognostic model for TC survival, showing good calibration and discrimination ability. Further analyses are needed and could be focused on an external validation of this model.",
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T1 - Prognostic model of survival for typical bronchial carcinoid tumours

T2 - Analysis of 1109 patients on behalf of the European Association of Thoracic Surgeons (ESTS) Neuroendocrine Tumours Working Group

AU - Filosso, Pier Luigi

AU - Guerrera, Francesco

AU - Evangelista, Andrea

AU - Welter, Stefan

AU - Thomas, Pascal

AU - Casado, Paula Moreno

AU - Rendina, Erino Angelo

AU - Venuta, Federico

AU - Ampollini, Luca

AU - Brunelli, Alessandro

AU - Stella, Franco

AU - Nosotti, Mario

AU - Raveglia, Federico

AU - Larocca, Valentina

AU - Rena, Ottavio

AU - Margaritora, Stefano

AU - Ardissone, Francesco

AU - Travis, William D.

AU - Sarkaria, Inderpal

AU - Sagan, Dariusz

AU - Yuste, Mariano Garcia

AU - Lim, Eric

AU - Papagiannopoulos, Konstantinos

AU - Asamura, Hisao

PY - 2015

Y1 - 2015

N2 - OBJECTIVES: Typical carcinoids (TCs) are uncommon, slow-growing neoplasms, usually with high 5-year survival rates. As these are rare tumours, their management is still based on small clinical observations and no international guidelines exist. Based on the European Society of Thoracic Surgeon Neuroendocrine TumoursWorking Group (NET-WG) Database, we evaluated factors that may influence TCs mortality. METHODS: Using the NET-WG database, an analysis on TC survival was performed. Overall survival (OS) was calculated starting from the date of intervention. Predictors of OS were investigated using the Cox model with shared frailty (accounting for the within-centre correlation). Candidate predictors were: gender, age, smoking habit, tumour location, previous malignancy, Eastern Cooperative Oncology Group (ECOG) performance status (PS), pT, pN, TNM stage and tumour vascular invasion. The final model included predictors with P = 0.15 after a backward selection. Missing data in the evaluated predictors were multiple-imputed and combined estimates were obtained from five imputed data sets. RESULTS: For 58 of 1167 TC patients vital status was unavailable and analyses were therefore performed on 1109 patients from 17 institutions worldwide. During a median follow-up of 50 months, 87 patients died, with a 5-year OS rate of 93.7% (95% confidence interval: 91.7-95.3). Backward selection resulted in a prediction model for mortality containing age, gender, previous malignancies, peripheral tumour, TNM stage and ECOG PS. The final model showed a good discrimination ability with a C-statistic equal to 0.836 (bootstrap optimism-corrected 0.806). CONCLUSIONS: We presented and validated a promising prognostic model for TC survival, showing good calibration and discrimination ability. Further analyses are needed and could be focused on an external validation of this model.

AB - OBJECTIVES: Typical carcinoids (TCs) are uncommon, slow-growing neoplasms, usually with high 5-year survival rates. As these are rare tumours, their management is still based on small clinical observations and no international guidelines exist. Based on the European Society of Thoracic Surgeon Neuroendocrine TumoursWorking Group (NET-WG) Database, we evaluated factors that may influence TCs mortality. METHODS: Using the NET-WG database, an analysis on TC survival was performed. Overall survival (OS) was calculated starting from the date of intervention. Predictors of OS were investigated using the Cox model with shared frailty (accounting for the within-centre correlation). Candidate predictors were: gender, age, smoking habit, tumour location, previous malignancy, Eastern Cooperative Oncology Group (ECOG) performance status (PS), pT, pN, TNM stage and tumour vascular invasion. The final model included predictors with P = 0.15 after a backward selection. Missing data in the evaluated predictors were multiple-imputed and combined estimates were obtained from five imputed data sets. RESULTS: For 58 of 1167 TC patients vital status was unavailable and analyses were therefore performed on 1109 patients from 17 institutions worldwide. During a median follow-up of 50 months, 87 patients died, with a 5-year OS rate of 93.7% (95% confidence interval: 91.7-95.3). Backward selection resulted in a prediction model for mortality containing age, gender, previous malignancies, peripheral tumour, TNM stage and ECOG PS. The final model showed a good discrimination ability with a C-statistic equal to 0.836 (bootstrap optimism-corrected 0.806). CONCLUSIONS: We presented and validated a promising prognostic model for TC survival, showing good calibration and discrimination ability. Further analyses are needed and could be focused on an external validation of this model.

KW - Lung

KW - Metastases

KW - Neuroendocrine tumours

KW - Prognostic score

KW - Recurrence

KW - Surgery

KW - Survival

KW - Typical carcinoid

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