Table 1.
Clinical characteristics and clinicopathological features associated with lymph node disease
| Characteristic | All Patients | Without Lymph Node disease (N0) N= 81 |
With Lymph Node disease (N1 or N2) N= 17 |
Univariable Analysis (p value) |
|---|---|---|---|---|
| Age, years | 0.65 | |||
| Median-years (range) | 58(19–84) | 58 (19–84) | 56 (36–78) | |
| Race | 0.57 | |||
| White | 67 (68.4%) | 54 (66.7%) | 13 (76.5%) | |
| Non-White | 31 (31.6%) | 27 (33.3%) | 4 (23.5%) | |
| Sex | 1.00 | |||
| Male | 24 (24.5%) | 20 (24.7%) | 4 (23.5%) | |
| Female | 74 (75.5%) | 61 (75.3%) | 13 (76.5%) | |
| Prior Smoking History | 1.00 | |||
| Yes | 32 (32.7%) | 27 (33.3%) | 5 (29.4%) | |
| No | 66 (67.3%) | 54 (66.7%) | 12 (70.6%) | |
| Prior Malignancy | 0.43 | |||
| Yes | 12 (12.2%) | 9 (11.1%) | 3 (17.6%) | |
| No | 86 (87.8%) | 72 (88.9%) | 14 (82.4%) | |
| Second Primary Cancer (non- lung carcinoid) | 0.20 | |||
| Yes | 10 (10.2%) | 10 (12.3%) | 0 (0%) | |
| No | 88 (89.8%) | 71 (87.7%) | 17 (100%) | |
| Functional Syndrome1 | 0.58 | |||
| Yes | 10 (10.2%) | 8 (9.9%) | 2 (11.8%) | |
| No | 37 (37.8%) | 29 (35.8%) | 8 (47.1%) | |
| Not specified | 51 (52.0%) | 44 (54.3%) | 7 (41.2%) | |
| Preoperative Systemic Imaging Performed2 | ||||
| CT | 85 (86.7%) | 70 (86.4%) | 15 (88.2%) | 1.00 |
| 18FDG PET | 58 (59.2%) | 50 (61.7%) | 8 (47.1%) | 0.29 |
| SSTR Imaging | 18 (18.4%) | 12 (14.8%) | 6 (35.3%) | 0.08 |
| Suspected Lymph Node Involvement on Preoperative Imaging | 0.13 | |||
| Yes | 15 (15.3%) | 10 (12.3%) | 5 (29.4%) | |
| No | 83 (84.7%) | 71 (87.7%) | 12 (70.6%) | |
| Location of Tumor | 0.42 | |||
| Central | 57 (58.2%) | 49 (60.5%) | 8 (47.1%) | |
| Peripheral | 41 (41.8%) | 32 (39.5%) | 9 (52.9%) | |
| Tumor Laterality | 0.40 | |||
| Right | 35 (35.7%) | 27 (33.3%) | 8 (47.1%) | |
| Left | 63 (64.3%) | 54 (66.7%) | 9 (52.9%) | |
| Surgical Approach | 0.83 | |||
| Thoracotomy | 73 (74.5%) | 59 (72.8%) | 14 (82.4%) | |
| VATS | 23 (23.5%) | 20 (24.7%) | 3 (17.6%) | |
| Robotic | 2 (2.0%) | 2 (2.5%) | 0 (0%) | |
| Extent of Surgery | 1.00 | |||
| Lobectomy | 89 (90.8%) | 73 (90.1%) | 16 (94.1%) | |
| Sublobar resection | 9 (9.2%) | 8 (9.9%) | 1 (5.9%) | |
| Number of Lymph Nodes Sampled, median [range] | 9[1–32] | 9 (1–30) | 9 (1–32) | 1.00 |
| Tumor Size (pathologic), median [range] | 2.1 [0.7–9.0] | 2.1 (0.7–9.0) | 2.5 (0.7–4.5) | 0.91 |
| Number of Lymph Node Stations Sampled median [range] | 4 [1–10] | 4[1–10] | 4 [1–8] | 0.62 |
| Primary Tumor | 0.57 | |||
| T1a | 50 (51.0%) | 42 (51.9%) | 8 (47.1%) | |
| T1b | 24 (24.5%) | 21 (25.9%) | 3 (17.6%) | |
| T2a | 20 (20.4%) | 14 (17.3%) | 6 (35.3%) | |
| T2b | 2 (2.0%) | 2 (2.5%) | 0 | |
| T3 | 2 (2.0%) | 2 (2.5%) | 0 | |
| Regional Lymph Nodes3 | ||||
| N0 | 81 (83.7%) | ---- | ---- | ---- |
| N1 | 11 (10.2%) | ---- | ---- | ---- |
| N2 | 6 (6.1%) | ---- | ---- | ---- |
| Distant Metastases | ||||
| M0 | 98 (100%) | ---- | ---- | ---- |
| M1a | 0 | ---- | ---- | ---- |
| M1b | 0 | ---- | ---- | ---- |
| Overall Stage (n=98)4 | ||||
| IA | 63 (64.3%) | ---- | ---- | ---- |
| IB | 14 (14.3%) | ---- | ---- | ---- |
| IIA | 11 (11.2%) | ---- | ---- | ---- |
| IIB | 4 (4.1%) | ---- | ---- | ---- |
| IIIA | 6 (6.1%) | ---- | ---- | ---- |
| IIIB | 0 | ---- | ---- | ---- |
| IV | 0 | ---- | ---- | ---- |
| Histologic Diagnosis | 0.40 | |||
| Typical Carcinoid | 87 (88.8%) | 73 (90.1%) | 14 (82.4%) | |
| Atypical Carcinoid | 11 (11.2%) | 8 (4.9%) | 3 (17.6%) | |
| Resection Status | ||||
| Complete | 94 (95.9%) | 79 (97.5%) | 15 (88.2%) | 0.14 |
| Incomplete | 4 (4.1%) | 2 (2.5%) | 2 (11.8%) | |
| Mitotic Index (mitosis/2 mm2) | 0.10 | |||
| <2 | 91 (92.9%) | 77 (95.1%) | 14 (82.4%) | |
| 2–10 | 7 (7.1%) | 4 (4.9%) | 3 (17.6%) | |
| Necrosis | 0.65 | |||
| Yes | 9 (9.2%) | 7 (8.6%) | 2 (11.8%) | |
| No | 89 (90.8%) | 74 (91.4%) | 15 (88.2%) | |
| Recurrence | ||||
| Yes | 10 (10.2%) | 5 (6.2%) | 5 (29.4%) | 0.013 |
| No | 88 (89.8%) | 76 (93.8%) | 12 (70.6%) |
Abbreviations: 18FDGPET =Fludeoxyglucose Positron Emission Tomography; CT = Computed Tomography; SSTR imaging = Somatostatin Receptor imaging includes OctreoScan = Octreotide Scan and 68Ga-DOTATATE PET = 68 Gallium-DOTATATE Positron Emission Tomography; VATS = video-assisted thoracic surgery.
1.
Carcinoid Syndrome was detected in 8 patients and Cushing’s Syndrome in 2 patients.
2.
9 had OctreoScan, 11 had 68Ga-DOTATATE PET scans, and 2 had both.