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H. Isaksson



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    P1.06 - Poster Session/ Screening and Early Detection (ID 218)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Screening and Early Detection
    • Presentations: 1
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      P1.06-015 - A Population Based Study on Pulmonary Carcinoids in Iceland: Epidemiology, Diagnosis and Survival Over Sixty Years (ID 2158)

      09:30 - 09:30  |  Author(s): H. Isaksson

      • Abstract
      • Slides

      Background:
      Pulmonary carcinoids are usually localized to the lungs but can also metastasize to mediastinal lymph nodes or to other organs. We studied the incidence and patient outcome in a well-defined population over a 60 year period.

      Methods:
      A nationwide study, including all pulmonary carcinoids diagnosed in Iceland from 1955 to 2014. Histologic specimens were re-evaluated and information retrieved from medical records. The tumors were staged according to the TNM staging system (6[th] edition). Survival was estimated using the Kaplan-Meier method, with end of follow-up on January 1[st] 2015. Mean follow-up was 186 months.

      Results:
      93 patients (62 females, average age of 52 years) were diagnosed during the 60 year period. Incidence increased from 0,2/100.000/year between 1955-1964 to 0,7 2005-2014. A total of 26 out of 85 patients (31%) were asymptomatic upon diagnosis and the rate of incidental detection increased from 17% in the first 30 years to 33% in the later 30 years. The most common symptoms were cough (56%), pneumonia (28%) and chest pain (11%). Mean tumor diameter was 2,7 cm (range: 0,3-6,3), 71 (84%) patients were diagnosed with typical carcinoid tumors and 14(16%) with atypical carcinoid tumors. Out of 77(91%) patients who had surgery, 65(84%) underwent a lobectomy. One patient died within 30 days of surgery. Most patients(n=67, 79%) were on stage I upon diagnosis and 4(5%) on stage II. Another 4 patients were on stage III with mediastinal lymph node metastases, all with typical histology. Out of six patients(7%) with distal metastases (stage IV), two had typical histology. Five patients(6%) had died from pulmonary carcinoids upon follow-up, but total 5-year survival was 92% for all patients and 87% for patients with typical carcinoids.

      Conclusion:
      The incidence of pulmonary carcinoids in Iceland has tripled over the last 6 decades, mostly due to steep increase in incidental detection on chest imaging. Most patients (>84%) are diagnosed with a localized disease, where long-term outcome is excellent.

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