Survival outcomes and prognostic factors in surgically resected lung carcinoids: A 25-year retrospective analysis

Background: Carcinoids are rare neuroendocrine lung cancers with a prognosis related to stage and grade. Radical and complete surgical resection is the only curative treatment. However, some prognostic factors influencing survival outcomes must be fully understood. This study aims to evaluate the clinical and pathological characteristics of lung carcinoids and identify key predictors of recurrence-free survival and overall survival. Methods: A retrospective analysis was conducted on patients with histologically confirmed lung carcinoids (typical and atypical) who underwent surgical resection between January 1998 and December 2023. Clinical data, including age, gender, smoking status, tumor laterality, TNM stage, and pathological features, were collected. Survival outcomes were analyzed using Kaplan-Meier curves, log-rank tests, and Cox proportional hazards regression models. Results: The cohort of 524 patients had a median age of 62 years, with 65.6 % females. Most carcinoids were typical (73.7 %) and located on the right side (59.4 %). Advanced tumor stage and higher mitotic counts were significantly associated with poorer survival. No significant impact on survival was observed for surgical techniques or factors such as age, sex, or histology. In particular, laterality shows no statistically significant difference in OS between the two groups (p = 0.35). Conclusion: In our extensive series of patients with resected lung carcinoids, tumor stage and mitotic count were critical predictors of survival. While surgical resection is essential, these findings underscore the importance of precise staging and pathological evaluation to inform treatment decisions and enhance patient outcomes.