Abstract:
Lung carcinoid tumours are neuroendocrine neoplasms originating from the bronchopulmonary tract\'s neuroendocrine cells, accounting for only 1%-3% of all lung cancers but 30% of all neuroendocrine tumours. The incidence of lung carcinoids, both typical and atypical, has been increasing over the years due to improved diagnostic methods and increased awareness among clinicians and pathologists. The most recent WHO classification includes a subgroup of lung carcinoids with atypical morphology and higher mitotic count and/or Ki67 labelling index. Despite appropriate surgery, the 5-year survival rate for atypical carcinoids barely exceeds 50%-70%. The role of adjuvant therapy in lung carcinoids is not well-defined, and clinical decisions are generally based on the presence of high-risk features. Long-term follow-up is essential to monitor for recurrence, although the optimal follow-up protocol remains unclear. To address the lack of consensus in clinical management decisions, the European Neuroendocrine Tumor Society (ENETS) initiated a survey among 20 expert centres. The survey identified varied opinions on approaches to imaging, surgery, use of adjuvant therapy, and follow-up protocols. Notably, the absence of dedicated multidisciplinary lung neuroendocrine tumour boards in some centres was evident. Experts agreed on the need for a prospective adjuvant trial in high-risk patients, emphasizing the feasibility of such a study. In conclusion, the study highlights the need for a more uniform adoption of existing guidelines in the management of lung carcinoid tumours and emphasizes the importance of international collaboration to advance research and patient care. Close collaboration between healthcare providers and patients is vital for effective long-term surveillance and management of these rare tumours.
摘要:
肺类癌瘤是起源于支气管肺系神经内分泌细胞的神经内分泌肿瘤,仅占所有肺癌的1%-3%,但占所有神经内分泌肿瘤的30%。肺类癌的发病率,既典型又非典型,多年来,由于诊断方法的改进以及临床医生和病理学家的认识提高,这种情况一直在增加。最新的WHO分类包括具有非典型形态和较高有丝分裂计数和/或Ki67标记指数的肺类癌亚组。尽管进行了适当的手术,非典型类癌的5年生存率勉强超过50%-70%.辅助治疗在肺类癌中的作用尚不明确,和临床决策通常基于高风险特征的存在。长期随访对于监测复发至关重要,尽管最佳随访方案尚不清楚.为了解决临床管理决策中缺乏共识的问题,欧洲神经内分泌肿瘤学会(ENETS)在20个专家中心发起了一项调查.调查发现了关于成像方法的不同意见,手术,使用辅助治疗,和后续协议。值得注意的是,一些中心没有专门的多学科肺神经内分泌肿瘤委员会是显而易见的.专家们一致认为有必要在高危患者中进行前瞻性辅助试验,强调这种研究的可行性。总之,该研究强调需要更统一地采用现有的肺类癌瘤治疗指南,并强调国际合作促进研究和患者护理的重要性.医疗保健提供者和患者之间的密切合作对于有效的长期监测和管理这些罕见肿瘤至关重要。