Pulmonary neuroendocrine carcinomas: A population-based survey

Abstract

17522 Background: Pulmonary neuroendocrine tumors are currently subdivided into four major subgroups named typical carcinoid (TC), atypical carcinoid (AC), small cell lung cancer (SCLC), and large cell neuroendocrine carcinoma (LNEC). Despite similarities in pathological features and a possible common cell of origin, the clinical outcomes are markedly different with a spectrum of aggressiveness from low-grade TC to high grade SCLC. Available studies however, are limited by the small number of patients. We conducted a population survey to further define the demographics and outcomes for these patients. Methods: The Surveillance Epidemiology End Results (SEER) database was searched for patients with TC, AC, SCLC, and LNEC diagnosed between 2000 and 2003. Only patients with known stage and survival data were included in the analysis. To allow a better definition of tumor behavior in each subset of patients, the cancer-specific survival was calculated for all stages, stage I treated by surgery, and stage IV. Results: There were 19,531 patients eligible including 1,230 TC, 75 AC, 17,821 SCLC, and 405 LNEC. Median age was 58, 61, 67, and 66 years respectively. The highest proportion of patients aged ≤ 40 was seen in TC and AC (17% and 12% respectively), and the lowest in LNEC and SCLC (2.2 and 0.7%). TC and AC were more common in women (62% and 61%) whereas LNEC and SCLC were more common in men (55% and 52%). Stage I was seen most commonly in TC and AC (77% and 52% respectively), whereas stage IV was more common in SCLC (58%). Three-year cancer-specific survival for all stages, stage I treated by surgery, and stage IV are described in the table below. Conclusions: TC and AC are more common in women, had the highest proportion of younger patients, usually presented with earlier stages, and had better outcomes. LNEC is associated with better cancer-specific survival compared with SCLC. Table TC AC SCLC LNEC Overall survival 94% 76% 8.5% 27% 3-year survival for resected stage I 98% 95% 55% 65% 3-year survival for stage IV 62% 23% 2.5% 6.4% No significant financial relationships to disclose.