Outcomes of Curative-Intent Surgery and Adjuvant Treatment for Pulmonary Large Cell Neuroendocrine Carcinoma
Background Pulmonary large cell neuroendocrine carcinoma (LCNEC) is pathologically classified as non-small-cell lung cancer (NSCLC), but its clinical behavior is more aggressive than other types of NSCLC. Accordingly, the optimal treatment strategy for LCNEC, including the indication of adjuvant tre...
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| Veröffentlicht in: | World journal of surgery 2017-07, Vol.41 (7), p.1820-1827 |
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| creator | Kim, Kun Woo Kim, Hong Kwan Kim, Jhingook Shim, Young Mog Ahn, Myung-Ju Choi, Yoon-La |
| description | Background
Pulmonary large cell neuroendocrine carcinoma (LCNEC) is pathologically classified as non-small-cell lung cancer (NSCLC), but its clinical behavior is more aggressive than other types of NSCLC. Accordingly, the optimal treatment strategy for LCNEC, including the indication of adjuvant treatment, remains controversial.
Methods
A retrospective review of 139 patients who underwent curative-intent surgery for LCNEC was performed to investigate clinicopathologic features and survival outcomes and to evaluate whether adjuvant treatment affected survival outcomes.
Results
The mean patient age was 64 years (126 men, 90.6%). Operative procedures included 111 lobectomies (79.8%), 12 pneumonectomies (8.6%), and 2 sublobar resections. Pathologic stage was IA in 31 (22%), IB in 36 (26%), IIA in 34 (24%), IIB in 9 (6%), IIIA in 19 (14%), IIIB in 2 (1.4%), and IV in 4 patients (2.9%). Postoperatively, 50 patients (36%) received adjuvant treatment. The median follow-up duration was 33 months. The 5-year overall survival (OS) rate was 53%, and 5-year disease-free survival (DFS) rate was 39%. In patients with pathologic stage I, there was no significant difference in either OS or DFS according to the addition of adjuvant treatment. However, in patients with pathologic stage II or higher, patients who underwent adjuvant treatment showed significantly better OS (
p
= 0.023) and DFS (
p
= 0.038).
Conclusions
Our findings showed that patients who underwent curative-intent surgery for LCNEC benefitted from the use of adjuvant treatment especially in pathologic stage II or higher. |
| doi_str_mv | 10.1007/s00268-017-3908-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1869069724</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1869069724</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4221-35f76dab9d852b1797ef0257ff42e82223a01f7ec4f0fdf1b99958692c4170b23</originalsourceid><addsrcrecordid>eNqFkU9rFTEUxYMo9ln9AG5kwI2b0Zub-ZMs68Nq5dEKrbgMmZlE5jGT1GRS6bf3PqaKFEpXCTe_czi5h7HXHN5zgPZDAsBGlsDbUiiQpXzCNrwSWKJA8ZRtQDQV3bk4Yi9S2gOBDTTP2RFKhEpx2LDpIi99mG0qgiu2OZplvLHlmV-sX4rLHH_aeFsYPxQnwz7fGBpeRWuW-fDsQiy-5WkO3hC0MwQXWztNxbnNMVg_hD6OnmYm9qMPs3nJnjkzJfvq7jxm308_XW2_lLuLz2fbk13ZV4i8FLVrm8F0apA1drxVrXWAdetchVYiojDAXWv7yoEbHO-UUrVsFPYVb6FDcczerb7XMfzKNi16HlNPyYy3ISfNCYZGtVgR-vYeug85ekqnOTGilnVzoPhK9TGkFK3T13Gc6deagz5UodcqNG1YH6rQkjRv7pxzN9vhn-Lv7glQK_B7nOzt4476x9fLj6cgBeekxVWbSOappP9iP5joDxZEpHM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1906358564</pqid></control><display><type>article</type><title>Outcomes of Curative-Intent Surgery and Adjuvant Treatment for Pulmonary Large Cell Neuroendocrine Carcinoma</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>SpringerLink Journals - AutoHoldings</source><creator>Kim, Kun Woo ; Kim, Hong Kwan ; Kim, Jhingook ; Shim, Young Mog ; Ahn, Myung-Ju ; Choi, Yoon-La</creator><creatorcontrib>Kim, Kun Woo ; Kim, Hong Kwan ; Kim, Jhingook ; Shim, Young Mog ; Ahn, Myung-Ju ; Choi, Yoon-La</creatorcontrib><description>Background
Pulmonary large cell neuroendocrine carcinoma (LCNEC) is pathologically classified as non-small-cell lung cancer (NSCLC), but its clinical behavior is more aggressive than other types of NSCLC. Accordingly, the optimal treatment strategy for LCNEC, including the indication of adjuvant treatment, remains controversial.
Methods
A retrospective review of 139 patients who underwent curative-intent surgery for LCNEC was performed to investigate clinicopathologic features and survival outcomes and to evaluate whether adjuvant treatment affected survival outcomes.
Results
The mean patient age was 64 years (126 men, 90.6%). Operative procedures included 111 lobectomies (79.8%), 12 pneumonectomies (8.6%), and 2 sublobar resections. Pathologic stage was IA in 31 (22%), IB in 36 (26%), IIA in 34 (24%), IIB in 9 (6%), IIIA in 19 (14%), IIIB in 2 (1.4%), and IV in 4 patients (2.9%). Postoperatively, 50 patients (36%) received adjuvant treatment. The median follow-up duration was 33 months. The 5-year overall survival (OS) rate was 53%, and 5-year disease-free survival (DFS) rate was 39%. In patients with pathologic stage I, there was no significant difference in either OS or DFS according to the addition of adjuvant treatment. However, in patients with pathologic stage II or higher, patients who underwent adjuvant treatment showed significantly better OS (
p
= 0.023) and DFS (
p
= 0.038).
Conclusions
Our findings showed that patients who underwent curative-intent surgery for LCNEC benefitted from the use of adjuvant treatment especially in pathologic stage II or higher.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-017-3908-8</identifier><identifier>PMID: 28204910</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Adjuvant Chemotherapy ; Adjuvant therapy ; Adjuvant Treatment ; Adult ; Age ; Aged ; Aged, 80 and over ; Cancer ; Carcinoma, Neuroendocrine - mortality ; Carcinoma, Neuroendocrine - pathology ; Carcinoma, Neuroendocrine - therapy ; Carcinoma, Non-Small-Cell Lung - mortality ; Carcinoma, Non-Small-Cell Lung - pathology ; Carcinoma, Non-Small-Cell Lung - therapy ; Cardiac Surgery ; Chemotherapy, Adjuvant ; Female ; General Surgery ; Humans ; Indication ; Lung cancer ; Lung Neoplasms - therapy ; Male ; Medicine ; Medicine & Public Health ; Men ; Middle Aged ; Neuroendocrine tumors ; Non-small cell lung carcinoma ; Optimization ; Original Scientific Report ; Overall Survival ; Pathologic Stage ; Patients ; Pneumonectomy ; Retrospective Studies ; Small Cell Lung Cancer ; Surgery ; Survival ; Thoracic Surgery ; Treatment Outcome ; Vascular Surgery</subject><ispartof>World journal of surgery, 2017-07, Vol.41 (7), p.1820-1827</ispartof><rights>Société Internationale de Chirurgie 2017</rights><rights>2017 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>World Journal of Surgery is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4221-35f76dab9d852b1797ef0257ff42e82223a01f7ec4f0fdf1b99958692c4170b23</citedby><cites>FETCH-LOGICAL-c4221-35f76dab9d852b1797ef0257ff42e82223a01f7ec4f0fdf1b99958692c4170b23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-017-3908-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-017-3908-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,41464,42533,45550,45551,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28204910$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Kun Woo</creatorcontrib><creatorcontrib>Kim, Hong Kwan</creatorcontrib><creatorcontrib>Kim, Jhingook</creatorcontrib><creatorcontrib>Shim, Young Mog</creatorcontrib><creatorcontrib>Ahn, Myung-Ju</creatorcontrib><creatorcontrib>Choi, Yoon-La</creatorcontrib><title>Outcomes of Curative-Intent Surgery and Adjuvant Treatment for Pulmonary Large Cell Neuroendocrine Carcinoma</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
Pulmonary large cell neuroendocrine carcinoma (LCNEC) is pathologically classified as non-small-cell lung cancer (NSCLC), but its clinical behavior is more aggressive than other types of NSCLC. Accordingly, the optimal treatment strategy for LCNEC, including the indication of adjuvant treatment, remains controversial.
Methods
A retrospective review of 139 patients who underwent curative-intent surgery for LCNEC was performed to investigate clinicopathologic features and survival outcomes and to evaluate whether adjuvant treatment affected survival outcomes.
Results
The mean patient age was 64 years (126 men, 90.6%). Operative procedures included 111 lobectomies (79.8%), 12 pneumonectomies (8.6%), and 2 sublobar resections. Pathologic stage was IA in 31 (22%), IB in 36 (26%), IIA in 34 (24%), IIB in 9 (6%), IIIA in 19 (14%), IIIB in 2 (1.4%), and IV in 4 patients (2.9%). Postoperatively, 50 patients (36%) received adjuvant treatment. The median follow-up duration was 33 months. The 5-year overall survival (OS) rate was 53%, and 5-year disease-free survival (DFS) rate was 39%. In patients with pathologic stage I, there was no significant difference in either OS or DFS according to the addition of adjuvant treatment. However, in patients with pathologic stage II or higher, patients who underwent adjuvant treatment showed significantly better OS (
p
= 0.023) and DFS (
p
= 0.038).
Conclusions
Our findings showed that patients who underwent curative-intent surgery for LCNEC benefitted from the use of adjuvant treatment especially in pathologic stage II or higher.</description><subject>Abdominal Surgery</subject><subject>Adjuvant Chemotherapy</subject><subject>Adjuvant therapy</subject><subject>Adjuvant Treatment</subject><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cancer</subject><subject>Carcinoma, Neuroendocrine - mortality</subject><subject>Carcinoma, Neuroendocrine - pathology</subject><subject>Carcinoma, Neuroendocrine - therapy</subject><subject>Carcinoma, Non-Small-Cell Lung - mortality</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Carcinoma, Non-Small-Cell Lung - therapy</subject><subject>Cardiac Surgery</subject><subject>Chemotherapy, Adjuvant</subject><subject>Female</subject><subject>General Surgery</subject><subject>Humans</subject><subject>Indication</subject><subject>Lung cancer</subject><subject>Lung Neoplasms - therapy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Men</subject><subject>Middle Aged</subject><subject>Neuroendocrine tumors</subject><subject>Non-small cell lung carcinoma</subject><subject>Optimization</subject><subject>Original Scientific Report</subject><subject>Overall Survival</subject><subject>Pathologic Stage</subject><subject>Patients</subject><subject>Pneumonectomy</subject><subject>Retrospective Studies</subject><subject>Small Cell Lung Cancer</subject><subject>Surgery</subject><subject>Survival</subject><subject>Thoracic Surgery</subject><subject>Treatment Outcome</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkU9rFTEUxYMo9ln9AG5kwI2b0Zub-ZMs68Nq5dEKrbgMmZlE5jGT1GRS6bf3PqaKFEpXCTe_czi5h7HXHN5zgPZDAsBGlsDbUiiQpXzCNrwSWKJA8ZRtQDQV3bk4Yi9S2gOBDTTP2RFKhEpx2LDpIi99mG0qgiu2OZplvLHlmV-sX4rLHH_aeFsYPxQnwz7fGBpeRWuW-fDsQiy-5WkO3hC0MwQXWztNxbnNMVg_hD6OnmYm9qMPs3nJnjkzJfvq7jxm308_XW2_lLuLz2fbk13ZV4i8FLVrm8F0apA1drxVrXWAdetchVYiojDAXWv7yoEbHO-UUrVsFPYVb6FDcczerb7XMfzKNi16HlNPyYy3ISfNCYZGtVgR-vYeug85ekqnOTGilnVzoPhK9TGkFK3T13Gc6deagz5UodcqNG1YH6rQkjRv7pxzN9vhn-Lv7glQK_B7nOzt4476x9fLj6cgBeekxVWbSOappP9iP5joDxZEpHM</recordid><startdate>201707</startdate><enddate>201707</enddate><creator>Kim, Kun Woo</creator><creator>Kim, Hong Kwan</creator><creator>Kim, Jhingook</creator><creator>Shim, Young Mog</creator><creator>Ahn, Myung-Ju</creator><creator>Choi, Yoon-La</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>201707</creationdate><title>Outcomes of Curative-Intent Surgery and Adjuvant Treatment for Pulmonary Large Cell Neuroendocrine Carcinoma</title><author>Kim, Kun Woo ; Kim, Hong Kwan ; Kim, Jhingook ; Shim, Young Mog ; Ahn, Myung-Ju ; Choi, Yoon-La</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4221-35f76dab9d852b1797ef0257ff42e82223a01f7ec4f0fdf1b99958692c4170b23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Abdominal Surgery</topic><topic>Adjuvant Chemotherapy</topic><topic>Adjuvant therapy</topic><topic>Adjuvant Treatment</topic><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cancer</topic><topic>Carcinoma, Neuroendocrine - mortality</topic><topic>Carcinoma, Neuroendocrine - pathology</topic><topic>Carcinoma, Neuroendocrine - therapy</topic><topic>Carcinoma, Non-Small-Cell Lung - mortality</topic><topic>Carcinoma, Non-Small-Cell Lung - pathology</topic><topic>Carcinoma, Non-Small-Cell Lung - therapy</topic><topic>Cardiac Surgery</topic><topic>Chemotherapy, Adjuvant</topic><topic>Female</topic><topic>General Surgery</topic><topic>Humans</topic><topic>Indication</topic><topic>Lung cancer</topic><topic>Lung Neoplasms - therapy</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Men</topic><topic>Middle Aged</topic><topic>Neuroendocrine tumors</topic><topic>Non-small cell lung carcinoma</topic><topic>Optimization</topic><topic>Original Scientific Report</topic><topic>Overall Survival</topic><topic>Pathologic Stage</topic><topic>Patients</topic><topic>Pneumonectomy</topic><topic>Retrospective Studies</topic><topic>Small Cell Lung Cancer</topic><topic>Surgery</topic><topic>Survival</topic><topic>Thoracic Surgery</topic><topic>Treatment Outcome</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Kun Woo</creatorcontrib><creatorcontrib>Kim, Hong Kwan</creatorcontrib><creatorcontrib>Kim, Jhingook</creatorcontrib><creatorcontrib>Shim, Young Mog</creatorcontrib><creatorcontrib>Ahn, Myung-Ju</creatorcontrib><creatorcontrib>Choi, Yoon-La</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Kun Woo</au><au>Kim, Hong Kwan</au><au>Kim, Jhingook</au><au>Shim, Young Mog</au><au>Ahn, Myung-Ju</au><au>Choi, Yoon-La</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of Curative-Intent Surgery and Adjuvant Treatment for Pulmonary Large Cell Neuroendocrine Carcinoma</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2017-07</date><risdate>2017</risdate><volume>41</volume><issue>7</issue><spage>1820</spage><epage>1827</epage><pages>1820-1827</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Background
Pulmonary large cell neuroendocrine carcinoma (LCNEC) is pathologically classified as non-small-cell lung cancer (NSCLC), but its clinical behavior is more aggressive than other types of NSCLC. Accordingly, the optimal treatment strategy for LCNEC, including the indication of adjuvant treatment, remains controversial.
Methods
A retrospective review of 139 patients who underwent curative-intent surgery for LCNEC was performed to investigate clinicopathologic features and survival outcomes and to evaluate whether adjuvant treatment affected survival outcomes.
Results
The mean patient age was 64 years (126 men, 90.6%). Operative procedures included 111 lobectomies (79.8%), 12 pneumonectomies (8.6%), and 2 sublobar resections. Pathologic stage was IA in 31 (22%), IB in 36 (26%), IIA in 34 (24%), IIB in 9 (6%), IIIA in 19 (14%), IIIB in 2 (1.4%), and IV in 4 patients (2.9%). Postoperatively, 50 patients (36%) received adjuvant treatment. The median follow-up duration was 33 months. The 5-year overall survival (OS) rate was 53%, and 5-year disease-free survival (DFS) rate was 39%. In patients with pathologic stage I, there was no significant difference in either OS or DFS according to the addition of adjuvant treatment. However, in patients with pathologic stage II or higher, patients who underwent adjuvant treatment showed significantly better OS (
p
= 0.023) and DFS (
p
= 0.038).
Conclusions
Our findings showed that patients who underwent curative-intent surgery for LCNEC benefitted from the use of adjuvant treatment especially in pathologic stage II or higher.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>28204910</pmid><doi>10.1007/s00268-017-3908-8</doi><tpages>8</tpages></addata></record> |
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| subjects | Abdominal Surgery Adjuvant Chemotherapy Adjuvant therapy Adjuvant Treatment Adult Age Aged Aged, 80 and over Cancer Carcinoma, Neuroendocrine - mortality Carcinoma, Neuroendocrine - pathology Carcinoma, Neuroendocrine - therapy Carcinoma, Non-Small-Cell Lung - mortality Carcinoma, Non-Small-Cell Lung - pathology Carcinoma, Non-Small-Cell Lung - therapy Cardiac Surgery Chemotherapy, Adjuvant Female General Surgery Humans Indication Lung cancer Lung Neoplasms - therapy Male Medicine Medicine & Public Health Men Middle Aged Neuroendocrine tumors Non-small cell lung carcinoma Optimization Original Scientific Report Overall Survival Pathologic Stage Patients Pneumonectomy Retrospective Studies Small Cell Lung Cancer Surgery Survival Thoracic Surgery Treatment Outcome Vascular Surgery |
| title | Outcomes of Curative-Intent Surgery and Adjuvant Treatment for Pulmonary Large Cell Neuroendocrine Carcinoma |
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