OBJECTIVE: Large cell neuroendocrine carcinoma of the lung are considered aggressive. However, reported prognoses are heterogeneous and the optimum treatment remains undefined. We retrospectively evaluated outcomes in a series of patients with a pathological diagnosis of large cell neuroendocrine lung carcinoma, who underwent lung resection. We also assessed the utility of chemotherapy in a small subgroup. PATIENTS AND METHODS: The clinical records of 144 consecutive patients were reviewed in a multicenter study. Survival times, assessed from the day of surgery until death or most recent follow-up, were estimated by the Kaplan-Meier method, and compared by the log rank test. RESULTS: There were 117 men and 27 women of median age 63 years. Twelve wedge resections, 3 segmentectomies, 95 lobectomies, 7 bilobectomies and 24 pneumonectomies were performed. Induction chemotherapy was given in 21 and postoperative chemotherapy in 24. Pathologically, 73 (50%) were stage I, 29 (20%) stage II, 40 (28%) stage III and 2 stage IV. Postoperative mortality was 2.8% and morbidity 26%. Overall 5-year survival was 42.5%: 52% for stage I, 59% for stage II and 20% for stage III (p=0.001 log-rank test on Kaplan-Meier curves). A trend to better outcome was associated with preoperative or postoperative chemotherapy in stage I disease (p=0.077) compared to no chemotherapy. The response rate to induction chemotherapy was 80% in the 15 patients with data available. CONCLUSION: large cell neuroendocrine carcinoma of the lung are confirmed as aggressive but are also chemosensitive. Our experience suggests that chemotherapy may improve prognosis in stage I disease.
OBJECTIVE: Large cell neuroendocrine carcinoma of the lung are considered aggressive. However, reported prognoses are heterogeneous and the optimum treatment remains undefined. We retrospectively evaluated outcomes in a series of patients with a pathological diagnosis of large cell neuroendocrine lung carcinoma, who underwent lung resection. We also assessed the utility of chemotherapy in a small subgroup. PATIENTS AND METHODS: The clinical records of 144 consecutive patients were reviewed in a multicenter study. Survival times, assessed from the day of surgery until death or most recent follow-up, were estimated by the Kaplan-Meier method, and compared by the log rank test. RESULTS: There were 117 men and 27 women of median age 63 years. Twelve wedge resections, 3 segmentectomies, 95 lobectomies, 7 bilobectomies and 24 pneumonectomies were performed. Induction chemotherapy was given in 21 and postoperative chemotherapy in 24. Pathologically, 73 (50%) were stage I, 29 (20%) stage II, 40 (28%) stage III and 2 stage IV. Postoperative mortality was 2.8% and morbidity 26%. Overall 5-year survival was 42.5%: 52% for stage I, 59% for stage II and 20% for stage III (p=0.001 log-rank test on Kaplan-Meier curves). A trend to better outcome was associated with preoperative or postoperative chemotherapy in stage I disease (p=0.077) compared to no chemotherapy. The response rate to induction chemotherapy was 80% in the 15 patients with data available. CONCLUSION: large cell neuroendocrine carcinoma of the lung are confirmed as aggressive but are also chemosensitive. Our experience suggests that chemotherapy may improve prognosis in stage I disease.
Authors: Vignesh Raman; Oliver K Jawitz; Chi-Fu J Yang; Soraya L Voigt; Betty C Tong; Thomas A D'Amico; David H Harpole Journal: J Thorac Oncol Date: 2019-09-23 Impact factor: 15.609
Authors: Jarushka Naidoo; Maria L Santos-Zabala; Tunc Iyriboz; Kaitlin M Woo; Camelia S Sima; John J Fiore; Mark G Kris; Gregory J Riely; Piro Lito; Afsheen Iqbal; Stephen Veach; Stephanie Smith-Marrone; Inderpal S Sarkaria; Lee M Krug; Charles M Rudin; William D Travis; Natasha Rekhtman; Maria C Pietanza Journal: Clin Lung Cancer Date: 2016-01-21 Impact factor: 4.785
Authors: Maria Cattoni; Eric Vallières; Lisa M Brown; Amir A Sarkeshik; Stefano Margaritora; Alessandra Siciliani; Pier Luigi Filosso; Francesco Guerrera; Andrea Imperatori; Nicola Rotolo; Farhood Farjah; Grace Wandell; Kimberly Costas; Catherine Mann; Michal Hubka; Stephen Kaplan; Alexander S Farivar; Ralph W Aye; Brian E Louie Journal: World J Surg Date: 2019-07 Impact factor: 3.352
Authors: Pier Luigi Filosso; Piero Ferolla; Francesco Guerrera; Enrico Ruffini; William D Travis; Giulio Rossi; Paolo Olivo Lausi; Alberto Oliaro Journal: J Thorac Dis Date: 2015-04 Impact factor: 2.895
Authors: Vignesh Raman; Oliver K Jawitz; Chi-Fu J Yang; Betty C Tong; Thomas A D'Amico; Mark F Berry; David H Harpole Journal: Ann Thorac Surg Date: 2019-04-18 Impact factor: 4.330