MA12.10 Treatment and Survival Differences in Patients with Large Cell Neuroendocrine Carcinoma of the Lung: A SEER Database Analysis

Abstract

Large cell neuroendocrine carcinoma of the lung (L-LCNEC) is a rare but highly aggressive tumor. We aimed to determine the differences in treatment and survival in L-LCNEC and to identify predictors for survival using Surveillance, Epidemiology, and End-Results (SEER) data. Data of patients diagnosed with L-LCNEC in 2004–2015 were retrieved. Age, sex, race, and tumor site, size, grade, and stage were evaluated. Multivariable logistic and Cox regression were performed to identify factors associated with overall survival (OS) and cancer-specific survival (CSS). Table 1Univariate and multivariate analyses of overall survival (OS) in the eligible patients. A total of 2,838 eligible cases were enrolled at the time of L-LCNEC diagnosis. In total, 1,774 (62.5%), 796 (28.0%), and 268 (9.5%) patients were diagnosed at the ages of 60-79, <60, and ≥80 years, respectively. L-LCNEC incidence (83.6%, N=2,373) was significantly high among Caucasians. Most tumors were in the right (56.2%, N=1,594) upper (53.5%, N=1519) lung lobe. Grade III (34.7%) and stage IV (49.0%) diseases were commonly detected in men (56.1%). Old age (60-79 years, hazard ratio [HR] [95% confidence interval]: 1.352 [1.136-1.609], P=0.001; ≥80 years, 1.841 [1.313-2.582], P<0.0001), stage III (2.053 [1.371-3.074], P<0.0001) and IV (3.878 [2.595-5.796], P<0.0001), and tumor size >5 cm (1.391[1.071-1.808], P=0.013) were independent unfavorable prognostic factors. Surgery (0.553 [0.397-0.770], P<0.0001) and chemotherapy (0.455 [0.392-0.528], P<0.001) were significant independent favorable prognostic factors. Patients treated with surgery, chemotherapy, or surgery plus chemotherapy had the lowest distant metastases rates.View Large Image Figure ViewerDownload Hi-res image Download (PPT) We provide population-based estimates of the incidence and prognosis of L-LCNEC. Surgery and chemotherapy significantly improved the OS and CSS of patients with L-LCNEC.