This protocol addresses the management of a small-stage (cT1N0) lung carcinoid presenting in the specific context of multiple endocrine neoplasia type 1 (MEN-1), diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH), or in patients whose comorbidities alter the risk–benefit calculation for standard surgical intervention.
In patients with cT1N0 lung carcinoid arising within DIPNECH, in the setting of MEN-1 syndrome, or where significant comorbid conditions are present, the characteristically indolent course of most tumours becomes a central factor in clinical decision-making. The appropriate management path in these situations differs from that applied to sporadic carcinoids in otherwise fit patients — the structured protocol lays out the evidence-based approach for this specific population.
DOI: 10.1016/j.annonc.2021.01.003
Watchful radiological follow-up, as an alternative to surgery, may be considered in case of cT1N0 carcinoid within the setting of DIPNECH, but also in MEN-1 patients and patients with comorbid conditions, due to the indolent course of most tumours [IV, C].
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