PURPOSE: The aim of the study was to determine the value of reclassification of neuroendocrine tumours and to analyse the characteristics of patients with recurrence after surgery.
METHODS: 110 surgical resected tumours were retrieved. All tumours were reclassified according to the WHO classification of 2004.
RESULTS: The diagnoses on 48 tumours (44%) were changed, (23 cases) were changed from “carcinoid NOS” to typical carcinoid (TC) (19 cases), atypical carcinoid (AC) (3 cases) and no diagnosis (too small for rediagnosis). Eight cases were originally diagnosed as “malignant carcinoid” and rediagnosed as AC (5 cases), large cell neuroendocrine carcinoma (LCNEC) (2 cases) and SCLC combined (1 case). 45% were men, and LCNEC and SCLC combined were significantly more common in men than in women whereas TC and AC were more common in women. An endobronchial component was observed in 54% of TC, 31% of AC and 11% of LCNEC. Sixty-nine of the patients were in stage I (43 TC, 9 AC, 15 LCNEC, 2 SCLC), 8 were in stage II (1 TC, 2 AC, 3 LCNEC, 2 SCLC), 15 were in stage III (2 TC, 3 AC, 7 LCNEC, 3 SCLC) and 1 patient was in stage IV (AC). Median follow-up was 4.4 years (range 0.5–20 years) and the reclassification separated the tumours better than the original diagnoses in relation to overall survival (p<0.001). 20 patients (6% of TC, 50% of AC, and 21% of LCNEC) developed recurrence after surgery: 8 in the lung, 7 in the liver, 2 in the cerebrum, 2 multiple organs, 2 in cerebrum and 1 in the mediastinum.
CONCLUSION: Before using material in retrospective studies all NE tumours must be rediagnosed as the classification of lung tumours has changed over the last 20 years.
CLINICAL IMPLICATIONS: Because of the high rate of recurrence in patients with AC, special attention to the follow up of this group of patient is important. The follow up should be concentrated on these organs.
DISCLOSURE: Mark Krasnik, No Financial Disclosure Information; No Product/Research Disclosure Information