The Role of Systemic Therapy in the Management of Stage I Large Cell Neuroendocrine Carcinoma of the Lung

Kujtan, Lara; Muthukumar, Varsha; Kennedy, Kevin F.; Davis, John R.; Masood, Ashiq; Subramanian, Janakiraman

doi:10.1016/j.jtho.2018.01.019

Cited by 48 publications

(62 citation statements)

References 35 publications

(46 reference statements)

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“…Similar results were obtained by other authors, such that 3-and 5-year recurrence-free survival was reported in 45% and 38-39.3% of patients, respectively [3,30,34]. Many recurrent tumors as distant metastases were observed in LCNEC patients with complete resection [20,21,37]. Therefore, surgery alone could be insufficient to treat patients with LCNEC and adjuvant therapy may be necessary [36,38].…”

Section: Discussionsupporting

confidence: 85%

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Outcomes of Patients with Clinical Stage I-IIIA Large-Cell Neuroendocrine Lung Cancer Treated with Resection

Łowczak

Kolasińska-Ćwikła

Ćwikła

et al. 2020

JCM

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Large-cell neuroendocrine carcinoma (LCNEC) is a rare malignancy with poor prognosis. The rationale of the study was to determine the survival of LCNEC patients in I–IIIA clinical stages who underwent resection. A total of 53 LCNEC (89%) and combined LCNEC (11%) patients in stages I–IIIA who underwent surgery with radical intent between 2002–2018 were included in the current study. Overall survival (OS) and time to recurrence (TTR) were estimated. Uni- and multivariable analyses were conducted using Cox-regression model. Patients were treated with surgery alone (51%), surgery with radiochemotherapy (4%), with radiotherapy (2%), with adjuvant chemotherapy (41%), or with neoadjuvant chemotherapy (2%). The median (95% Confidence Interval (CI)) OS and TTR was 52 months (20.1–102.1 months) and 20 months (7.0–75.6 months), respectively. Patients treated in clinical stage I showed better OS than patients in stages II–IIIA (p = 0.008). Patients with R0 resection margin (negative margin, no tumor at the margin) and without lymph node metastasis had significantly better TTR. In the multivariate analysis, age was an independent factor influencing OS. Recurrence within 1 year was noted in more than half cases of LCNEC. R0 resection margin and N0 status (no lymph node metastasis) were factors improving TTR. Age >64 years was observed as a main independent factor influencing OS.

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Section: Discussionsupporting

confidence: 85%

“…Most data are based on retrospective analysis. Kujtan L et al [21] conducted a retrospective evaluation of LCNEC patients with surgically resected stage I of the disease and found that improved survival was achieved by chemotherapy in both stage IA and IB patients.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Patients with Clinical Stage I-IIIA Large-Cell Neuroendocrine Lung Cancer Treated with Resection

Łowczak

Kolasińska-Ćwikła

Ćwikła

et al. 2020

JCM

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“…There are limited studies assessing how age impacts prognosis due to the low incidence of pulmonary LCNEC. Kujtan and colleagues reported that patients over 70 had worse survival outcomes (Kujtan et al 2018). Additionally, Wu et al confirmed that age was a prognostic factor for pulmonary neuroendocrine tumors, which, however, only included 23 patients (5.7%) with pulmonary LCNEC (Wu et al 2014).…”

Section: Discussionmentioning

confidence: 99%

Peer Review #1 of "Clinicopathological characteristics and prognosis of pulmonary large cell neuroendocrine carcinoma aged ≥65 years (v0.2)"

2019

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Objective: The present study was designed to better characterize the clinicopathological features and prognosis in patients aged ≥ 65 years with pulmonary LCNEC. Methods: Eligible patients with pulmonary LCNEC were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database between January 2004 and December 2013. The primary endpoints included cancer specific survival (CSS) and overall survival (OS). Results: Data of 1,619 eligible patients with pulmonary LCNEC were collected. These patients were subsequently categorized into two groups: 890 patients in the older group (age 65 years), and 729 in the younger group (age < 65 years). More patients were of white ethnicity, stage I, married, and with tumor size ˂5 cm in the older group in comparison to the younger group. However, there were a significantly lower proportion of patients undergoing surgery, chemotherapy and radiotherapy in the older group. The 5-year CSS rates of the younger group and older group were 23.94% and 17.94% (P =0.00031), respectively, and the 5-year OS rates were 20.51% and 13.47% (P ˂ 0.0001), respectively. Multivariate analyses indicated that older age

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“…L-LCNEC patients treated by surgery alone were rarely cured even in the early stage [26], which urges more scholars to consider chemotherapy or radiotherapy [6,18,27,28]. Two retrospective analysis showed that compared with the patients with surgery alone, platinum-based neoadjuvant chemotherapy or postoperative adjuvant chemotherapy could prolong the recurrence time of tumor and significantly benefit the longterm survival for the patients with early stage [29,30]. Chemotherapy regimens for small cell lung cancer/non-small cell lung cancer were used in L-LCNEC treatment, but most of the data were came from single center, small sample or retrospective studies, and the results were controversial [7,31,32].…”

Section: Discussionmentioning

confidence: 99%

Construction of a nomogram to predict overall survival for patients with lung large cell neuroendocrine carcinoma: analysis of the SEER database

Han

Gao

et al. 2020

Preprint

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Background Lung large cell neuroendocrine carcinoma (L-LCNEC) has a poor prognosis with lower survival rate than other NSCLC patients. The estimation of an individual survival rate is puzzling. The main purpose of this study was to establish a more accurate model to predict the prognosis of L-LCNEC.Methods Patients aged 18 years or older with L-LCNEC were identified from the Surveillance, Epidemiology and End Results (SEER) database from 2004 to 2015. Cox regression analysis was used to identify factors associated with survival time. The results were used to construct a nomogram to predict 1-year, and 3-year survival probability in L-LCNEC patients. Overall survival (OS) were compared between low risk group and high risk group by the Kaplan–Meier analysis.Results A total of 3216 patients were included in the study. We randomly divided all included patients into 7:3 training and validating groups. In multivariable analysis of training cohort, age at diagnosis, sex, stage of tumor, surgical treatment, radiotherapy and chemotherapy were independent prognostic factors for OS. All these factors were incorporated to construct a nomogram, which was tested in the validating cohort.Conclusions we constructed a visual nomogram prognosis model, which had the potential to predict the 1-year and 3-year survival rate of L-LCNEC patients, and could be used as an assistant prediction tool in clinical practice.

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The Role of Systemic Therapy in the Management of Stage I Large Cell Neuroendocrine Carcinoma of the Lung

Abstract: In this largest-reported retrospective study of patients with resected stage I LCNEC, survival was improved in patients who received chemotherapy in both stage IA and stage IB LCNEC.

Cited by 48 publications

References 35 publications

Outcomes of Patients with Clinical Stage I-IIIA Large-Cell Neuroendocrine Lung Cancer Treated with Resection

Outcomes of Patients with Clinical Stage I-IIIA Large-Cell Neuroendocrine Lung Cancer Treated with Resection

Peer Review #1 of "Clinicopathological characteristics and prognosis of pulmonary large cell neuroendocrine carcinoma aged ≥65 years (v0.2)"

Construction of a nomogram to predict overall survival for patients with lung large cell neuroendocrine carcinoma: analysis of the SEER database

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