Original Article
Outcomes of patients with large cell neuroendocrine carcinoma of the lung after complete resection
Abstract
Background: Large cell neuroendocrine carcinoma (LCNEC) of the lung is a relatively uncommon, aggressive, and preoperatively difficult-to-diagnosis malignancy. Treatment outcomes have not been extensively investigated.
Methods: A cohort of 90 patients who underwent surgical resection and systematic nodal dissection for LCNEC between 2008 and 2014 at a single institution was retrospectively reviewed.
Results: The 90 patients included 80 males and 10 females, with an average age of 62 years. The median survival was 34 months. The 5-year overall survival (OS) and disease-free survival (DFS) were 36.3% and 32.2%, respectively. Multivariate analyses using Cox’s proportional hazards models showed that smoking history [no vs. yes, hazards ratio (HR) =0.390; 95% confidence interval (CI): 0.182–0.835; P=0.015], pathological stage (stage I vs. stage III, HR =0.098, 95% CI: 0.043–0.221; P<0.001; stage II vs. III, HR =0.119, 95% CI: 0.044–0.324, P<0.001), and postoperative chemotherapy (Yes vs. No, HR =0.223; 95% CI: 0.112–0.443; P<0.001) were significant prognostic factors for OS. Further analysis showed that after adjustment patients treated with a small cell lung cancer (SCLC) regimen had better survival than those treated with a non-small cell lung cancer (NSCLC) regimen (HR =0.420, 95% CI: 0.189–0.936, P=0.034).
Conclusions: Post-operative chemotherapy is beneficial for patients with completely resected and systematic nodal dissection. An SCLC-based chemotherapy regimen leads to better survival than a NSCLCbased regimen in patients with completely resected LCNEC.
Methods: A cohort of 90 patients who underwent surgical resection and systematic nodal dissection for LCNEC between 2008 and 2014 at a single institution was retrospectively reviewed.
Results: The 90 patients included 80 males and 10 females, with an average age of 62 years. The median survival was 34 months. The 5-year overall survival (OS) and disease-free survival (DFS) were 36.3% and 32.2%, respectively. Multivariate analyses using Cox’s proportional hazards models showed that smoking history [no vs. yes, hazards ratio (HR) =0.390; 95% confidence interval (CI): 0.182–0.835; P=0.015], pathological stage (stage I vs. stage III, HR =0.098, 95% CI: 0.043–0.221; P<0.001; stage II vs. III, HR =0.119, 95% CI: 0.044–0.324, P<0.001), and postoperative chemotherapy (Yes vs. No, HR =0.223; 95% CI: 0.112–0.443; P<0.001) were significant prognostic factors for OS. Further analysis showed that after adjustment patients treated with a small cell lung cancer (SCLC) regimen had better survival than those treated with a non-small cell lung cancer (NSCLC) regimen (HR =0.420, 95% CI: 0.189–0.936, P=0.034).
Conclusions: Post-operative chemotherapy is beneficial for patients with completely resected and systematic nodal dissection. An SCLC-based chemotherapy regimen leads to better survival than a NSCLCbased regimen in patients with completely resected LCNEC.
