INTRODUCTION Metastatic lung carcinoids (MLCs) remain poorly characterized and no prognostic stratification exists. METHODS We conducted a retrospective study including patients with MLCs in two European expert centers. The aims were to characterize these cases and to identify prognostic factors of survival and effectiveness of their treatments. RESULTS A total of 162 patients with MLC were included: 50% were women, and the median age was 61 years. Half of the patients had synchronous metastases, mainly located in the liver (75%), bone (42%), and lung (25%). According to WHO classification, MLCs were typical (28%), atypical (60%), or unspecified (12%). A functioning syndrome was observed in 43% of cases and an uptake at somatostatin receptor scintigraphy in 76% of cases. The 5-year overall survival rate was 60% and at 10 years this was 25%. In multivariate analysis, Eastern Cooperative Oncology Group performance status of 0-1 (hazard ratio [HR]: 5.81, 95% confidence interval [CI]: 2.10-16.11), uptake on SRS (HR: 0.38, 95% CI: 0.22-0.66), low serum chromogranin A (HR: 2.27, 95% CI: 1.36-3.81), and typical carcinoid (HR: 1.87, 95% CI: 1.26-2.78) were associated with better survival. According to Response Evaluation Criteria in Solid Tumors version 1.0, the highest objective response rates were obtained after radiofrequency ablation of metastases (86%), liver embolization (56%), peptide receptor radionuclide therapy (27%), and oxaliplatin-based chemotherapy (18%). CONCLUSIONS MLCs are characterized by a high frequency of atypical carcinoids, functioning syndrome, and liver/bone metastases. WHO classification, performance status, somatostatin receptor scintigraphy, and chromogranin A were associated with longer survival. Partial response was more frequent with locoregional therapies, peptide receptor radionuclide therapy, or oxaliplatin-based chemotherapy.

中文翻译：

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转移性肺类癌患者的特征、预后和治疗

引言 转移性肺类癌 (MLC) 的特征仍然很差，并且不存在预后分层。方法 我们进行了一项回顾性研究，纳入了两个欧洲专家中心的 MLC 患者。目的是描述这些病例的特征，并确定生存和治疗有效性的预后因素。结果 共纳入 162 名 MLC 患者：50% 为女性，中位年龄为 61 岁。一半的患者有同步转移，主要位于肝脏 (75%)、骨骼 (42%) 和肺 (25%)。根据 WHO 分类，MLC 为典型 (28%)、非典型 (60%) 或未指定 (12%)。在 43% 的病例中观察到功能性综合征，在 76% 的病例中观察到生长抑素受体闪烁扫描的摄取。5 年总生存率为 60%，10 年为 25%。在多变量分析中，东部肿瘤协作组的体能状态为 0-1（风险比 [HR]：5.81，95% 置信区间 [CI]：2.10-16.11），对 SRS 的吸收（HR：0.38，95% CI：0.22- 0.66)、低血清嗜铬粒蛋白 A (HR: 2.27, 95% CI: 1.36-3.81) 和典型类癌 (HR: 1.87, 95% CI: 1.26-2.78) 与更好的生存相关。根据实体瘤 1.0 版的反应评估标准，转移灶射频消融（86%）、肝栓塞（56%）、肽受体放射性核素治疗（27%）和奥沙利铂为基础的化疗后获得了最高的客观反应率（ 18%）。结论 MLCs 的特点是高频率的非典型类癌、功能综合征和肝/骨转移。WHO 分类、体能状态、生长抑素受体闪烁扫描、和嗜铬粒蛋白 A 与更长的生存期有关。局部治疗、肽受体放射性核素治疗或以奥沙利铂为基础的化疗更常出现部分反应。