Collectively, typical and atypical lung carcinoids are referred to as the well differentiated lung neuroendocrine cancers (pulmonary NETS). Pulmonary NETS account for only 2% of lung malignancies, however, account for 25% of the total NET presentations. The incidence and prevalence of these cancers is growing. Most pulmonary NETs tend to be localised at presentation and, therefore, amenable to surgical resection. Following surgical resection, there is very little evidence based guidance on how these patients should be followed up, what the risk factors for relapse are or whether there is a role for the administration of adjuvant therapy. Published guidelines are at odds with each other regarding this issue. It is clear that some cohorts of resected patients do relapse and may benefit from adjuvant treatment. However, currently these cohorts remain ill-defined. Furthermore, due to a historic scarcity of evidence, it is currently not clear what type of therapy should be used as adjuvant treatment. In recent years, better therapies with more robust evidence have emerged. Our basic understanding of pulmonary NETs is also improving. These factors in combination with an increasing incidence/ prevalence of the disease are bringing the question about adjuvant therapy back into sharp focus.
04 Dec 2017
UK and Ireland Neuroendocrine Tumour Society