Abstract
BackgroundPulmonary high-grade neuroendocrine carcinoma (HGNEC) has a rising incidence of developing second primary malignancies (SPMs). This study is the first population-based analysis to quantify the SPM risks among survivors of lung HGNEC.MethodsWe used the Surveillance, Epidemiology, and End Results (SEER) database to calculate standardized incidence ratio (SIR) and absolute excess risk (AER) between 2000 and 2016 for patients with pulmonary HGNEC. ResultsThe data of 1161 patients with SPMs were retrieved from the SEER database. The ratio of observed/expected number of SPMs in pulmonary HGNEC was 1.53. Solid tumours comprised 91% of all second malignancies in lung HGNEC patients, with the most common cancers reported in the oral cavity and pharynx, the urinary and respiratory systemsConclusionsOur study observed an increased risk of SPMs among patients with pulmongnancies.
Highlights
Pulmonary high-grade neuroendocrine carcinoma (HGNEC) has a rising incidence of developing second primary malignancies (SPMs)
Using a 6-month minimum interval, as is required to exclude synchronous primary cancers, we identified cases of histologically confirmed HGNEC with primary site codes (C34.0-main bronchus; C34.1-upper lobe, lung; C34.2middle lobe, lung; C34.3-lower lobe, lung; C34.8-overlapping lesion of the lung; and C34.9-lung, NOS) and ICD-0-3 Hist/Behav (8002/3: malignant tumour, small cell type; 8013/3: Large-cell neuroendocrine carcinoma; 8041/3: small cell carcinoma, NOS; 8042/3: oat cell carcinoma; 8043/3: small cell carcinoma, fusiform cell; 8044/3: small cell carcinoma, intermediate cell; and 8045/3: combined small cell carcinoma)
Between 2000 and 2016, 75,877 patients were diagnosed with pulmonary HGNEC and met inclusion criteria. 72, 381 patients with small cell carcinoma and 3496 patients with large-cell neuroendocrine carcinoma were included
Summary
Pulmonary high-grade neuroendocrine carcinoma (HGNEC) has a rising incidence of developing second primary malignancies (SPMs). Pulmonary high-grade neuroendocrine carcinoma (HGNEC), including small cell lung cancer (SCLC) and large cell neuroendocrine carcinoma (LCNEC), is a heterogeneous group of poorly differentiated neoplasms and covers 20% of all lung cancers. These two subtypes have relatively similar histological, genetic, and clinical characteristics, such as higher incidence in males and heavy smokers, as well as high mitotic rate and necrosis at histologic examination. According to research done by Wu and coworkers, the incidence of SPMs among patients with non-small cell lung cancer is about 6.4%. The risk of SPMs following a diagnosis of lung HGNEC remains unclear
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