Abstract
Large-cell neuroendocrine carcinoma (LCNEC) is a rare malignancy with poor prognosis. The rationale of the study was to determine the survival of LCNEC patients in I–IIIA clinical stages who underwent resection. A total of 53 LCNEC (89%) and combined LCNEC (11%) patients in stages I–IIIA who underwent surgery with radical intent between 2002–2018 were included in the current study. Overall survival (OS) and time to recurrence (TTR) were estimated. Uni- and multivariable analyses were conducted using Cox-regression model. Patients were treated with surgery alone (51%), surgery with radiochemotherapy (4%), with radiotherapy (2%), with adjuvant chemotherapy (41%), or with neoadjuvant chemotherapy (2%). The median (95% Confidence Interval (CI)) OS and TTR was 52 months (20.1–102.1 months) and 20 months (7.0–75.6 months), respectively. Patients treated in clinical stage I showed better OS than patients in stages II–IIIA (p = 0.008). Patients with R0 resection margin (negative margin, no tumor at the margin) and without lymph node metastasis had significantly better TTR. In the multivariate analysis, age was an independent factor influencing OS. Recurrence within 1 year was noted in more than half cases of LCNEC. R0 resection margin and N0 status (no lymph node metastasis) were factors improving TTR. Age >64 years was observed as a main independent factor influencing OS.
Highlights
Large-cell neuroendocrine carcinoma (LCNEC) is a rare and typically aggressive malignancy with poor prognosis [1]
In the 1970s, neuroendocrine tumors of the lungs were histologically classified into typical carcinoids, atypical carcinoids, and the undifferentiated category represented by small-cell lung cancer (SCLC) [9]
Kujtan L et al [21] conducted a retrospective evaluation of LCNEC patients with surgically resected stage I of the disease and found that improved survival was achieved by chemotherapy in both stage IA and IB patients
Summary
Large-cell neuroendocrine carcinoma (LCNEC) is a rare (only 2–3% of all primary lung cancers) and typically aggressive malignancy with poor prognosis [1]. In 1991, Travis et al [10] introduced a new category of lung cancer: a large-cell neuroendocrine carcinoma (LCNEC) characterized by large cells with a high mitotic rate and neuroendocrine features. LCNEC often exhibits large-cell morphology and features of neuroendocrine differentiation, including high mitotic rate (>10 mitoses per 10 high-power fields), low nuclear–cytoplasm ratio, and frequent areas of necrosis. Kujtan L et al [21] conducted a retrospective evaluation of LCNEC patients with surgically resected stage I of the disease and found that improved survival was achieved by chemotherapy in both stage IA and IB patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
