Vignesh Raman1, Oliver K Jawitz2, Chi-Fu J Yang3, Soraya L Voigt2, Betty C Tong2, Thomas A D'Amico2, David H Harpole2. 1. Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina. Electronic address: vignesh.raman@duke.edu. 2. Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina. 3. Department of Cardiothoracic Surgery, Department of Surgery, Stanford University Medical Center, Stanford, California.
Abstract
INTRODUCTION: There are limited small, single-institution observational studies examining the role of surgery in large cell neuroendocrine cancer (LCNEC). We investigated the outcomes of surgery for stage I to IIIA LCNEC by using the National Cancer Database. METHODS: Patients with stage I to IIIA LCNEC were identified in the National Cancer Database (2004-2015) and grouped by treatment: definitive chemoradiation versus surgery. Overall survival, by stage, was the primary outcome. Outcomes of surgical patients were also compared with those of patients with SCLC or other non-small cell histotypes. RESULTS: A total of 6092 patients met the criteria: 96%, 94%, 75%, and 62% of patients received an operation for stage I, II, IIIA, and cN2 disease, respectively. Complete resection was achieved in at least 85% of patients. The 5-year survival rates for patients undergoing an operation for stage I and II LCNEC were 50% and 45%, respectively. Surgical patients with stage IIIA and N2 disease had 36% and 32% 5-year survival rates, respectively. When compared with stereotactic body radiation in stage I disease and chemoradiation in patients with stage II to IIIA disease, surgery was associated with a survival benefit. Patients with LCNEC who underwent an operation generally experienced worse survival by stage than did those with adenocarcinoma but experienced improved survival compared with patients with SCLC. Perioperative chemotherapy was associated with improved survival for pathologic stage II to IIIA disease. CONCLUSIONS: Surgery is associated with reasonable outcomes for stage I to IIA LCNEC, although survival is generally worse than for adenocarcinoma. Surgery should be offered to medically fit patients with both early and locally advanced LCNEC, with guideline-concordant induction or adjuvant therapy.
INTRODUCTION: There are limited small, single-institution observational studies examining the role of surgery in large cell neuroendocrine cancer (LCNEC). We investigated the outcomes of surgery for stage I to IIIA LCNEC by using the National Cancer Database. METHODS:Patients with stage I to IIIA LCNEC were identified in the National Cancer Database (2004-2015) and grouped by treatment: definitive chemoradiation versus surgery. Overall survival, by stage, was the primary outcome. Outcomes of surgical patients were also compared with those of patients with SCLC or other non-small cell histotypes. RESULTS: A total of 6092 patients met the criteria: 96%, 94%, 75%, and 62% of patients received an operation for stage I, II, IIIA, and cN2 disease, respectively. Complete resection was achieved in at least 85% of patients. The 5-year survival rates for patients undergoing an operation for stage I and II LCNEC were 50% and 45%, respectively. Surgical patients with stage IIIA and N2 disease had 36% and 32% 5-year survival rates, respectively. When compared with stereotactic body radiation in stage I disease and chemoradiation in patients with stage II to IIIA disease, surgery was associated with a survival benefit. Patients with LCNEC who underwent an operation generally experienced worse survival by stage than did those with adenocarcinoma but experienced improved survival compared with patients with SCLC. Perioperative chemotherapy was associated with improved survival for pathologic stage II to IIIA disease. CONCLUSIONS: Surgery is associated with reasonable outcomes for stage I to IIA LCNEC, although survival is generally worse than for adenocarcinoma. Surgery should be offered to medically fit patients with both early and locally advanced LCNEC, with guideline-concordant induction or adjuvant therapy.
Authors: Babatunde A Yerokun; Chi-Fu Jeffrey Yang; Brian C Gulack; Xuechan Li; Michael S Mulvihill; Lin Gu; Xiaofei Wang; David H Harpole; Thomas A D'Amico; Mark F Berry; Matthew G Hartwig Journal: J Thorac Cardiovasc Surg Date: 2017-04-04 Impact factor: 5.209
Authors: Natasha Rekhtman; Maria C Pietanza; Matthew D Hellmann; Jarushka Naidoo; Arshi Arora; Helen Won; Darragh F Halpenny; Hangjun Wang; Shaozhou K Tian; Anya M Litvak; Paul K Paik; Alexander E Drilon; Nicholas Socci; John T Poirier; Ronglai Shen; Michael F Berger; Andre L Moreira; William D Travis; Charles M Rudin; Marc Ladanyi Journal: Clin Cancer Res Date: 2016-03-09 Impact factor: 12.531
Authors: Colin R Lindsay; Emily C Shaw; David A Moore; Doris Rassl; Mariam Jamal-Hanjani; Nicola Steele; Salma Naheed; Craig Dick; Fiona Taylor; Helen Adderley; Fiona Black; Yvonne Summers; Matt Evans; Alexandra Rice; Aurelie Fabre; William A Wallace; Siobhan Nicholson; Alex Haragan; Phillipe Taniere; Andrew G Nicholson; Gavin Laing; Judith Cave; Martin D Forster; Fiona Blackhall; John Gosney; Sanjay Popat; Keith M Kerr Journal: Br J Cancer Date: 2021-09-06 Impact factor: 9.075
Authors: Vignesh Raman; Oliver K Jawitz; Soraya L Voigt; Kristen E Rhodin; Thomas A D'Amico; David H Harpole; Chi-Fu Jeffrey Yang; Betty C Tong Journal: Chest Date: 2020-07-08 Impact factor: 9.410
Authors: Anna Lowczak; Agnieszka Kolasinska-Cwikla; Jarosław B Ćwikła; Karolina Osowiecka; Jakub Palucki; Robert Rzepko; Lidka Glinka; Anna Doboszyńska Journal: J Clin Med Date: 2020-05-07 Impact factor: 4.241
Authors: Hubertus Hautzel; Yazan Alnajdawi; Wolfgang P Fendler; Christoph Rischpler; Kaid Darwiche; Wilfried E Eberhardt; Lale Umutlu; Dirk Theegarten; Martin Stuschke; Martin Schuler; Clemens Aigner; Ken Herrmann; Till Plönes Journal: EJNMMI Res Date: 2021-07-22 Impact factor: 3.138