Survival and prognostic factors in operated bronchopulmonary carcinoid tumors

This study aimed to evaluate long-term survival outcomes in patients who underwent surgical treatment for bronchopulmonary carcinoid tumors, to determine prognostic factors, and to investigate the role of preoperative tomographic ROI index and calcification presence in histopathological subtype differentiation. Our study encompasses patients who underwent surgical resection for bronchopulmonary carcinoid tumors at İnönü University Turgut Özal Medical Center Department of Thoracic Surgery between January 1999 and December 2024. Demographic, clinical, radiological, pathological, and surgical characteristics of patients were evaluated. Survival analyses were performed using the Kaplan-Meier method. The patient group consisted of 58.3% males and 41.7% females, with a mean age of 54.7 years. Histopathological evaluation revealed 70% typical carcinoid and 30% atypical carcinoid. As surgical approach, VATS was used in 41.7% and thoracotomy in 58.3% of cases. In patients with a median follow-up period of 52 months, overall survival rates were found to be higher in typical carcinoids. In multivariate analysis, histological subtype, lymph node involvement, Ki-67 index, and ROI index were determined as independent prognostic factors for survival. ROI index showed high sensitivity and specificity in atypical carcinoid differentiation. Tomographic calcification was observed significantly more frequently in typical carcinoids. In conclusion, histological subtype, lymph node status, and Ki-67 proliferation index are fundamental prognostic factors in bronchopulmonary carcinoid tumors. Preoperative tomographic ROI index is a useful tool for histopathological subtype prediction and prognostic evaluation. Minimally invasive surgical approaches can be safely preferred in appropriate patients. Keywords: Bronchopulmonary carcinoid tumor, typical carcinoid, atypical carcinoid, survival, prognostic factors, ROI index, Ki-67 proliferation index, lymph node metastasis, VATS