Recurrence-Free Survival in Early and Locally Advanced Large Cell Neuroendocrine Carcinoma of the Lung after Complete Tumor Resection.
LCNEC
adjuvant therapy
age
lymph nodes
neuroendocrine tumor
prognosis
prognostic marker
pulmonary cancer
surgery
survival
Journal
Journal of personalized medicine
ISSN: 2075-4426
Titre abrégé: J Pers Med
Pays: Switzerland
ID NLM: 101602269
Informations de publication
Date de publication:
15 Feb 2023
15 Feb 2023
Historique:
received:
14
01
2023
revised:
09
02
2023
accepted:
13
02
2023
entrez:
25
2
2023
pubmed:
26
2
2023
medline:
26
2
2023
Statut:
epublish
Résumé
Large Cell Neuroendocrine Carcinoma (LCNEC) is a rare subtype of lung cancer with poor clinical outcomes. Data on recurrence-free survival (RFS) in early and locally advanced pure LCNEC after complete resection (R0) are lacking. This study aims to evaluate clinical outcomes in this subgroup of patients and to identify potential prognostic markers. Retrospective multicenter study including patients with pure LCNEC stage I-III and R0 resection. Clinicopathological characteristics, RFS, and disease-specific survival (DSS) were evaluated. Univariate and multivariate analyses were performed. 39 patients (M:F = 26:13), with a median age of 64 years (44-83), were included. Lobectomy (69.2%), bilobectomy (5.1%), pneumonectomy (18%), and wedge resection (7.7%) were performed mostly associated with lymphadenectomy. Adjuvant therapy included platinum-based chemotherapy and/or radiotherapy in 58.9% of cases. After a median follow-up of 44 (4-169) months, the median RFS was 39 months with 1-, 2- and 5-year RFS rates of 60.0%, 54.6%, and 44.9%, respectively. Median DSS was 72 months with a 1-, 2- and 5-year rate of 86.8, 75.9, and 57.4%, respectively. At multivariate analysis, age (cut-off 65 years old) and pN status were independent prognostic factors for both RFS (HR = 4.19, 95%CI = 1.46-12.07, After R0 resection of LCNEC, half of the patients recurred mostly within the first two years of follow-up. Age and lymph node metastasis could help to stratify patients for adjuvant therapy.
Sections du résumé
BACKGROUND
BACKGROUND
Large Cell Neuroendocrine Carcinoma (LCNEC) is a rare subtype of lung cancer with poor clinical outcomes. Data on recurrence-free survival (RFS) in early and locally advanced pure LCNEC after complete resection (R0) are lacking. This study aims to evaluate clinical outcomes in this subgroup of patients and to identify potential prognostic markers.
METHODS
METHODS
Retrospective multicenter study including patients with pure LCNEC stage I-III and R0 resection. Clinicopathological characteristics, RFS, and disease-specific survival (DSS) were evaluated. Univariate and multivariate analyses were performed.
RESULTS
RESULTS
39 patients (M:F = 26:13), with a median age of 64 years (44-83), were included. Lobectomy (69.2%), bilobectomy (5.1%), pneumonectomy (18%), and wedge resection (7.7%) were performed mostly associated with lymphadenectomy. Adjuvant therapy included platinum-based chemotherapy and/or radiotherapy in 58.9% of cases. After a median follow-up of 44 (4-169) months, the median RFS was 39 months with 1-, 2- and 5-year RFS rates of 60.0%, 54.6%, and 44.9%, respectively. Median DSS was 72 months with a 1-, 2- and 5-year rate of 86.8, 75.9, and 57.4%, respectively. At multivariate analysis, age (cut-off 65 years old) and pN status were independent prognostic factors for both RFS (HR = 4.19, 95%CI = 1.46-12.07,
CONCLUSION
CONCLUSIONS
After R0 resection of LCNEC, half of the patients recurred mostly within the first two years of follow-up. Age and lymph node metastasis could help to stratify patients for adjuvant therapy.
Identifiants
pubmed: 36836564
pii: jpm13020330
doi: 10.3390/jpm13020330
pmc: PMC9965978
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : Regione Campania
ID : POR Campania FESR 2014-2020
Organisme : Regione Campania
ID : "RARE.PLAT.NET" CUP B63D18000380007
Références
Ann Oncol. 2021 Jul;32(7):839-853
pubmed: 33864941
Cancer. 2009 Aug 1;115(15):3483-8
pubmed: 19536900
Onco Targets Ther. 2015 May 26;8:1219-27
pubmed: 26060407
Ann Oncol. 2017 Jul 1;28(suppl_4):iv1-iv21
pubmed: 28881918
Eur J Cardiothorac Surg. 2017 Aug 1;52(2):339-345
pubmed: 28459956
Clin Lung Cancer. 2020 Mar;21(2):e99-e113
pubmed: 31601526
Radiat Oncol J. 2021 Dec;39(4):288-296
pubmed: 34986550
Medicina (Kaunas). 2021 Jan 28;57(2):
pubmed: 33525370
Cancers (Basel). 2019 Sep 08;11(9):
pubmed: 31500357
J Clin Med. 2020 May 07;9(5):
pubmed: 32392725
Transl Cancer Res. 2020 Aug;9(8):4943-4957
pubmed: 35117856
Endocrine. 2022 Feb;75(2):623-634
pubmed: 34533768
Ann Thorac Surg. 2006 Nov;82(5):1802-7
pubmed: 17062251
J Thorac Cardiovasc Surg. 2009 Aug;138(2):446-53
pubmed: 19619794
Ann Thorac Surg. 2019 Aug;108(2):377-383
pubmed: 31004586
Med Sci Monit. 2019 May 16;25:3636-3646
pubmed: 31095532
J Thorac Dis. 2020 Mar;12(3):466-476
pubmed: 32274113
Anticancer Drugs. 2010 Jan;21(1):89-93
pubmed: 19770636
Nutrients. 2018 Dec 01;10(12):
pubmed: 30513732
Surg Oncol. 2022 May;41:101728
pubmed: 35227985
World J Surg. 2017 Jul;41(7):1820-1827
pubmed: 28204910
Ann Oncol. 2021 Dec;32(12):1637-1642
pubmed: 34481037
Orphanet J Rare Dis. 2021 Feb 12;16(1):82
pubmed: 33579331
Front Oncol. 2020 Dec 01;10:556194
pubmed: 33335851
Ann Thorac Surg. 2004 Jan;77(1):247-52; discussion 252-3
pubmed: 14726070
Endocrine. 2020 Aug;69(2):441-450
pubmed: 32468269
Front Endocrinol (Lausanne). 2021 Mar 18;12:649496
pubmed: 33815296
J Thorac Oncol. 2018 May;13(5):707-714
pubmed: 29391287
J Thorac Oncol. 2015 Aug;10(8):1133-41
pubmed: 26039012
Lung Cancer. 2006 Jul;53(1):111-5
pubmed: 16697073
Eur Respir J. 2016 Feb;47(2):615-24
pubmed: 26541538
Front Oncol. 2021 Mar 24;11:591823
pubmed: 33868992
World J Surg. 2019 Jul;43(7):1712-1720
pubmed: 30783763
J Thorac Oncol. 2016 Jan;11(1):39-51
pubmed: 26762738