• Song Xu, Xiongfei Li, Fan Ren, Jinling He, Shikang Zhao, Yanye Wang, Dian Ren, Shuai Zhu, Xi Lei, Gang Chen, and Jun Chen.
• Department of Lung Cancer Surgery.
• Ann. Surg. 2022 Dec 1; 276 (6): e991e999e991-e999.

ObjectiveThis study aimed to determine the optimal surgical procedure for early-stage pulmonary carcinoids (PCs).BackgroundPCs, comprising typical carcinoids (TCs) and atypical carcinoids (ACs), are rare low-grade malignant tumors. We determine the optimal surgical management for early-stage PCs using data from the Surveillance, Epidemiology, and End Results registry.MethodsClinical and survival data of patients with early-stage PC tumors with a diameter ≤3 cm were retrieved. The Kaplan-Meier method and logrank tests were used to assess the differences in overall survival (OS). Subgroup analyses were also performed. To reduce the inherent bias of retrospective studies, two propensity score matching (PSM) analysis with (PSM2) or without (PSM1) consideration of lymph node assessment were performed.ResultsIn total, 2934 patients with PCs, including 2741 (93.42%) with TCs and 193 (6.58%) with ACs, were recruited. After PSM1 analysis, TC patients in the lobectomy group had a significantly better OS than those in the sublobar resection group ( P = 0.0067), which is more remarkable for patients with a tumor diameter of 2 cm ConclusionsSublobar resection may not significantly compromise the longterm oncological outcomes in early-stage PCs ≤3 cm in size if lymph node assessment is performed adequately. Further validation in large randomized clinical trials is warranted.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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