Atypical bronchial carcinoid (ABC): recurrence-free survival after resection and analysis of therapeutic interventions

Atypical Bronchial Carcinoid (ABC)

Level

: Level 2

Launch date

: 1 March 2023

Principle investigators

: Eric BAUDIN

Project description

Background: Most bronchial carcinoids are diagnosed at stage I-II. Typical carcinoids (TC) represent 90% of this population. R0 resection of the tumor is achieved in 95% of cases. The recurrence rate mainly depends on the WHO classification and the TNM. The recurrence rate is higher in atypical carcinoids (AC): between 5 and 35% at 5 years. Unmet need: current studies which have analysed the post-operative follow-up of patients with atypical carcinoids are mainly retrospective and non-standardized in terms of imaging follow-up, questioning the current relapse figures, timing, and locations. Finally, the guideline does not recommend routine adjuvant treatment but a case-by-case discussion, mainly in atypical N-positive carcinoids. Future indication of adjuvant therapy may benefit from this kind of information. A randomised trial is not feasible in this setting due to the rarity of atypical carcinoids. Aim: Principal aims: Prospectively evaluation of recurrence-free survival at 5 and 10 years of patients with localized AC who benefit from a curative R0 resection Define of the anatomical sites of recurrence, the temporality, and the diagnostic methods Secondary aims: Define prognostic factors for RFS, including Ki67 in the WHO classification Median RFS and OS Analyse the types of interventions and results (new R0 Status) Assess the prognostic role of local EBRT therapeutic intervention (vs no local intervention) Assess the prognostic role of systemic interventions (vs no systemic intervention) for atypical bronchial carcinoids Analyse the molecular profile and its added prognostic value according to the proposal of Alcala et al Nat Com 2019 (ancillary study) Inclusion criteria: Atypical bronchial carcinoid histologically proven ,2015 WHO classification. Stage I-III UICC 2019 R0 surgery < 6 months Patient ≥ 18 year old Standardized follow-up according to ESMO 2020 guidelines Patient who has agreed to participates. Publication rules: Every participating institution will have 1 (co)-authorship, further participating persons of the same institution will be listed in the acknowledgement. If the number of co-authors has to be limited to a journals policy, the order will be determined according to the patient numbers recruited. The first author is the chairperson or PI of the study group of the study (designer/methodologist of the study). The second author is the best recruiter in terms of numbers and quality or the co-main author (if not the PI of the study). Subsequent author hierarchy is dependent on quality/quantity of recruitment/methodologist. The last author is the second chairperson/PI of the study (if among best recruiter). E. Baudin from Gustave Roussy, who coordinates the study, will be shared senior author.