Prognostic markers in resected large cell neuroendocrine carcinoma: A multicentre retrospective analysis

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Christian Roesel - , Bethanien Moers Hospital (Author)
  • Stefan Welter - , Hemer Hemer Lung Clinic Deutscher Gemeinschafts-Diakonieverband GmbH (Author)
  • Karl Otto Kambartel - , Bethanien Moers Hospital (Author)
  • Gerhard Weinreich - , University of Duisburg-Essen (Author)
  • Thomas Krbek - , Bethanien Moers Hospital (Author)
  • Monika Serke - , Hemer Hemer Lung Clinic Deutscher Gemeinschafts-Diakonieverband GmbH (Author)
  • Mohammed Ibrahim - , Hemer Hemer Lung Clinic Deutscher Gemeinschafts-Diakonieverband GmbH (Author)
  • Yazan Alnajdawi - , University of Duisburg-Essen (Author)
  • Till Plönes - , University of Duisburg-Essen (Author)
  • Clemens Aigner - , University of Duisburg-Essen (Author)

Abstract

Background: Large cell neuroendocrine carcinomas (LCNEC) are rare pulmonary malignancies. Reported survival rates are heterogeneous and the optimal therapeutic strategy is still debated. The prognosis of LCNEC is generally inferior compared to other non-small lung cancers. In early stages, surgery is recommended but might not be sufficient alone. Methods: We retrospectively analyzed all consecutive LCNEC patients operated at three institutions with curative intent between May 2005 and January 2017. Data retrieved from individual clinical databases were analyzed with the aim to identify prognostic parameters. Results: A total of 251 patients with LCNEC underwent curative intent surgery during the observation period. The median age was 64 years, 156 patients (62.2%) were male and 88.4% were smokers. The pathologic AJCC stage was I in 136 patients, II in 77, III in 33, and IV in 5 patients. Median followup was 26 months. Lymphatic vessel invasion (P=0.031) was identified as significant prognostic factor by multivariable analysis. There was a trend towards decreased survival in patients with blood vessel invasion (P=0.067). Even in earlier tumor stages, adjuvant chemotherapy had a positive effect on survival. The overall 1-, 3- and 5-year survival rates were 79.2%, 48.6% and 38.8% respectively. Conclusions: Lymphatic invasion (L1) is an independent prognostic factor. Surgery in LCNEC is beneficial in early tumor stages and platinum-based adjuvant chemotherapy may help in achieving better long-term outcomes resulting in most obvious survival differences in stage Ib.

Details

Original languageEnglish
Pages (from-to)466-476
Number of pages11
JournalJournal of thoracic disease
Volume12
Issue number3
Publication statusPublished - 1 Mar 2020
Peer-reviewedYes
Externally publishedYes

Keywords

Sustainable Development Goals

ASJC Scopus subject areas

Keywords

  • Curative resection, Large cell neuroendocrine carcinomas, Lymphatic invasion, Platinum-based adjuvant chemotherapy, Pulmonary malignancies