Clinicopathological prognostic factors in operated for pulmonary carcinoid tumor patients

Aim:to study the prognostic significance of N-status,pTNM stage,EGFR (Epidermal Growth Factor Receptor), mTOR(phosphorilated on Ser2442)(mamalian Target Of Rapamycin) protein expression and p70S6 kinase(phosphorilated on Ser411)expression in operated for pulmonary carcinoid tumor patients. Material and methods:Surgically resected specimen (men n=35;women n=42, mean age 48.5±13) from 64typical carcinoid(TC) and 13atypical carcinoid(AtC) patients were studied. The N-status(N0 n=68;N1/2 n=9),pTNM stage(I n=57; II n=13;III n=7) and immunohistochemical expression of EGFR (positive n=16/negative n=61), mTOR(positive n=34/negative n=43) and p70S6(>90% n=61/≤90% n=16)were evaluated.Statistical methods used:Kaplan-Meier,Wilcoxon,Cox regression analyses. Results:The 5 year survival for TCs was 88% and for AtCs–74%.The difference in mean survival time between TCs (125 months) and AtCs (72 months) was not significant(p=0.24).11% of the TCs were in N1/2 status and 15% of the AtCs were in N1/2 status. The 5 year survival for N0 was 89% and for N1/2–63% (p=0.085).The mean survival time was significantly longer in N0 status(N0-129 months,N1/2-87,p=0.005),in I and II pTNM status(I/II-125 months,III-38,p=0.005),in cases negative forEGFR (negative-128 months,positive-84,p=0.030), and in cases positive for mTOR (p=0.035). The Cox analysis confirmed the prognostic significance of N status(Hazard ratio[HR]5.25;p=0.012),pTNM stage(HR 14.14;p=0.019)and EGFR expression(HR 3.78;p=0.047). Conclusions:N0-status,pTNM I/II stage, lack of EGFRexpression and positive mTOR expression may represent favorable prognostic factors in pulmonary carcinoid tumors.