P1.12-17 Overall Survival and Recurrence After Surgical Resection of Pure and Mixed Large Cell Neuroendocrine Tumors

Abstract

Large-cell neuroendocrine carcinoma (LCNC) is an aggressive tumor with poor prognosis and undefined treatment. We performed a retrospective analysis on the outcomes of surgical resection and adjuvant therapy to assess the effectiveness of treatment. Retrospective review of patients with LCNC who underwent surgical resection at a single-center tertiary care facility from 2002-2017. Survival times were assessed from day of surgery until death. A Kaplan-Meier method for overall survival (OS) and for recurrence was used and compared across prognostic factors using log-rank analysis and a Cox proportional hazard model. Sixty-two patients were identified with a median follow up of 3.4 years. Of these, 26 (41.9%) were male and 56 (90.3%) were current or former smokers. The majority of patients underwent a lobectomy/segmentectomy (72.6%), while a smaller percentage (14.5%) underwent wedge resection, and the remainder pneumonectomy or bi-lobectomy (4.8%). Pathologically, 31 (54.4%) were stage I, 20 (35.1%) stage II, and 6 (10.5%) stage III-IV. Additionally, 35 (56.4%) represented pure LCNC while the remaining 27 (43.6%) had a mixed histology. Median OS for resected stage I disease was 11.3 years, decreased to 4.4 years in stage II disease, and was 0.8 years in stage III-IV disease (p = 0.01) (Figure 1). For those that recurred, median time to recurrence was 1.20 years for stage I and 1.15 years for stage II disease. Adjuvant therapy, type of resection, and tumor histology (pure vs. mixed) had no significant impact on OS on unadjusted or adjusted analysis. LCNC is associated with early recurrence after surgical resection and poor survival for patients with stage III and IV disease. In patients with mixed histology survival and recurrence remain similar to those with pure LCNC tumors.