TY  - JOUR
A1  - Altieri, Barbara
A1  - La Salvia, Anna
A1  - Modica, Roberta
A1  - Marciello, Francesca
A1  - Mercier, Olaf
A1  - Filosso, Pier Luigi
A1  - de Latour, Bertrand Richard
A1  - Giuffrida, Dario
A1  - Campione, Severo
A1  - Guggino, Gianluca
A1  - Fadel, Elie
A1  - Papotti, Mauro
A1  - Colao, Annamaria
A1  - Scoazec, Jean-Yves
A1  - Baudin, Eric
A1  - Faggiano, Antongiulio
T1  - Recurrence-free survival in early and locally advanced large cell neuroendocrine carcinoma of the lung after complete tumor resection
JF  - Journal of Personalized Medicine
N2  - 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: 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: 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, p = 0.008 and HR = 13.56, 95%CI 2.45–74.89, p = 0.003, respectively) and DSS (HR = 9.30, 95%CI 2.23–38.83, p = 0.002 and HR = 11.88, 95%CI 2.28–61.84, p = 0.003, respectively). Conclusion: 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.
KW  - neuroendocrine tumor
KW  - LCNEC
KW  - pulmonary cancer
KW  - prognostic marker
KW  - prognosis
KW  - survival
KW  - lymph nodes
KW  - age
KW  - surgery
KW  - adjuvant therapy
Y1  - 2023
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-304000
SN  - 2075-4426
VL  - 13
IS  - 2
ER  -