Treatment of Atypical Lung Carcinoid with N2 Lymph Node Metastases

Atypical lung carcinoid presenting with N2 nodal involvement represents a distinct, high-risk scenario within pulmonary neuroendocrine tumors — one where the risk of relapse is particularly elevated and treatment decisions are made after careful multidisciplinary evaluation.

This protocol addresses atypical lung carcinoid (AC) with N2 lymph node metastases — selected fit patients in whom the risk of relapse is considered particularly high. Management in this setting is guided by multidisciplinary discussion.

Surgical Approach

The preferred intervention involves anatomic pulmonary resection combined with systematic lymph node dissection. The full extent of resection, nodal station requirements, and additional treatment considerations are detailed in the complete protocol ›

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.annonc.2021.01.003

However, it may be considered in selected fit patients with particularly high risk of relapse (i.e. AC N2) after multidisciplinary discussion [IV, C].

Anatomic pulmonary resection (e.g. segmentectomy, lobectomy, bilobectomy, pneumonectomy) and lymph node resection (with a minimum of six nodal stations: three hilar and three mediastinal — also including subcarinal station — as recommended by the European Society of Thoracic Surgery for non-small-cell lung cancer) is the preferred extent of resection [IV, B].

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