Should large cell neuroendocrine carcinoma of the lung (LNEC) be classified and treated as a small cell lung cancer (SCLC) or with other large cell carcinomas (OLC)?

Abstract

7047 Background: To compare the presenting and prognostic characteristics, cause-specific survival (CSS) rates, and overall survival (OS) rates of patients with LNEC to those with SCLC or OLC, particularly those undergoing definitive resection without radiotherapy (S- NoRT). Methods: The Surveillance Epidemiology and End Results Database (SEER-17) from 2000-2006 was used. Differences between population characteristics were compared using chi-square and Kruskal-Wallis tests. The logrank test was used to compare differences in OS and CSS. Results: There were 1001 pts with LNEC (281 in the S-NoRT group), 9,417 patients with OLC (1212 S-noRT), and 35,047 SCLC patients (414 S-noRT). Patients with SCLC were more likely to be female, white non-Hispanic, and present with stage IV disease than patients with LNEC or OLC. Among S-no RT, those with SCLC were more likely to have nodal and mainstem bronchus involvement and to undergo a sublobar resection than patients with LNEC or OLC. Median follow-up in the S-noRT patients was 14 months (range, 3-83 months). OS and CSS of SCLC patients were significantly worse than that for patients with either LNEC or OLC. Multivariate analysis showed that OS was significantly affected by age, sex, stage, number of nodes resected or positive, and tumor size. When restricted to patients with stages T1A-BN0, CSS and OS remained worse in the SCLC group than the other groups. Conclusions: Presenting characteristics and survival of patients with LNEC are more similar to that of OLC than SCLC. Our results confirm patients with LNEC should be classified and treated as OLC. No significant financial relationships to disclose.