{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T23:13:56Z","timestamp":1767136436514,"version":"build-2238731810"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T00:00:00Z","timestamp":1651795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate risk factors for nodal upstaging in patients with lung carcinoids and to understand which type of lymphadenectomy is most appropriate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data regarding patients with lung carcinoids, who underwent surgical resection and lymphadenectomy in five institutions from January 1, 2005\u00a0to December 31, 2019, were collected and retrospectively analyzed. Clinical and pathological tumor characteristics were correlated to analyze lymph node upstaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The analysis was conducted on 283 patients. Pathology showed 230 typical and 53 atypical carcinoids. Nodal and mediastinal upstaging occurred in 33 (11.6%) and 16 (5.6%) patients, respectively. At the univariable analysis, nodal upstaging was significantly correlated with central location (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), atypical histology (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), pT dimension (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), and advanced age (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043). The multivariable analysis confirmed atypical histology (odds ratio\u00a0[OR]: 11.030; 95% confidence interval [CI]: 4.837\u221225.153,\u00a0\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and central location (OR: 3.295; 95%\u00a0CI: 1.440\u22127.540,\u00a0\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) as independent prognostic factors for nodal upstaging. Atypical histology (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), pT dimension (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.036), number of harvested lymph node stations (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047), and type of lymphadenectomy (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) correlated significantly with mediastinal upstaging. The multivariable analysis confirmed atypical histology (OR: 5.408;\u00a095% CI: 1.391\u221221.020,\u00a0\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015) and pT (OR: 1.052; 95%\u00a0CI: 1.021\u22121.084,\u00a0\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) as independent prognostic factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Atypical histology, dimension, and central location are associated with a high\u2010risk for occult hilo\u2010mediastinal metastases, and mediastinal radical dissection may predict nodal upstaging. Thus, we suggest radical mediastinal lymph node dissection in high\u2010risk tumors, reserving sampling, or lobe\u2010specific dissection in peripheral, small typical carcinoids.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.26912","type":"journal-article","created":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T11:29:49Z","timestamp":1651836589000},"page":"588-598","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Lymphadenectomy for lung carcinoids: Which factors may predict nodal upstaging? A multi centric, retrospective study"],"prefix":"10.1002","volume":"126","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3807-6911","authenticated-orcid":false,"given":"Marco","family":"Chiappetta","sequence":"first","affiliation":[{"name":"Thoracic Surgery Universit\u00e0 cattolica del Sacro Cuore Rome Italy"},{"name":"Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filippo","family":"Lococo","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Universit\u00e0 cattolica del Sacro Cuore Rome Italy"},{"name":"Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabella","family":"Sperduti","sequence":"additional","affiliation":[{"name":"Biostatistics, Regina Elena National Cancer Institute, IRCCS Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giacomo","family":"Cusumano","sequence":"additional","affiliation":[{"name":"Thoracic surgery, Policlinico\u2010San Marco Hospital Catania Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Terminella","sequence":"additional","affiliation":[{"name":"Thoracic surgery, Policlinico\u2010San Marco Hospital Catania Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ludovic","family":"Fournel","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Department, Cochin Hospital, APHP Centre University of Paris Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Guerrera","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, San Giovanni Battista Hospital University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"PierLuigi","family":"Filosso","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, San Giovanni Battista Hospital University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diomira","family":"Tabacco","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Universit\u00e0 cattolica del Sacro Cuore Rome Italy"},{"name":"Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samanta","family":"Nicosia","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, San Giovanni Battista Hospital University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Alifano","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Department, Cochin Hospital, APHP Centre University of Paris Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filippo","family":"Gallina","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, Regina Elena National Cancer Institute IRCCS\u2010IFO Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Facciolo","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, Regina Elena National Cancer Institute IRCCS\u2010IFO Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Margaritora","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Universit\u00e0 cattolica del Sacro Cuore Rome Italy"},{"name":"Fondazione Policlinico Universitario A. 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