@phdthesis{Guenster2021, author = {G{\"u}nster, Simone Andrea}, title = {Validierung eines klinischen Data Warehouses: Einsatz und M{\"o}glichkeiten in der Viszeralchirurgie}, doi = {10.25972/OPUS-24674}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-246743}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {Einleitung: In Zeiten des digitalen Fortschritts und wachsender Speicherkapazit{\"a}ten wird es m{\"o}glich, immer gr{\"o}ßere Datenmengen zu verarbeiten. Gleichzeitig besteht der Wunsch, aus diesen Daten neue Informationen im Sinne des „Information retrieval" zu gewinnen. PaDaWaN ist ein parametrisierbares Data Warehouse Framework zur effizienten Abfrage und Auswertung homogener und heterogener Datenbest{\"a}nde, das 2011 an der Universit{\"a}t W{\"u}rzburg entwickelt wurde. Methoden: Zur Validierung des Data Warehouses in der Viszeralchirurgie wurden die automatisiert generierten Daten aus PaDaWaN mit den manuell erhobenen Registerdaten des EuraHS Registers verglichen. Eingeschlossen wurden Patienten mit der Diagnose einer inzisionalen oder prim{\"a}r ventralen Hernie (n=510). Hierf{\"u}r wurden Informationen zu Diagnosen, Operationen und die intraoperativ verwendeten Materialien aus strukturierten und unstrukturierten Datenquellen des CIS ausgelesen. Das Maß der {\"U}bereinstimmung wurde mittels Cohens Kappa-Koeffizienten berechnet (IBM SPSS Statistics 24). Ergebnisse: Im Rahmen der Studie konnten Diskrepanzen zwischen strukturierten Datenquellen (ICD-10 Codes, OPS Codes) und unstrukturierten Datenquallen (Arztbriefe, Operationsberichte) aufgedeckt werden. Unstimmigkeiten in der ICD-10 Klassifikation f{\"u}r prim{\"a}r ventrale und inzisionale Hernien f{\"u}hrten zu einer deutlichen Untersch{\"a}tzung der inzisionalen umbilikalen Hernien. Sehr gute {\"U}bereinstimmungen wurden in den Kategorien Netzimplantation in IPOM-Technik, Underlay- und Sublay-Position erreicht. Faktoren, die die Konkordanz der Datens{\"a}tze beeinflussten, waren: Erfassung von Vordiagnosen, Voroperationen, mangelndes Erkennen von Negierungen und die Verwendung mehrerer Netze w{\"a}hrend einer Operation. Klassifikationen wie die "Dietz-Klassifikation" konnten automatisch erkannt und in ihre Bestandteile zerlegt werden. Fazit: Durch die Etablierung von Data Warehousing als Plattform f{\"u}r die klinische Forschung k{\"o}nnen Daten in Zukunft schneller strukturiert und generiert werden. Durch die dynamische t{\"a}gliche automatisierte Datenaktualisierung kann das klinische Personal Behandlungskonzepte und Ergebnisse schneller validieren und bewerten. Dar{\"u}ber hinaus k{\"o}nnen Empfehlungen f{\"u}r zuk{\"u}nftige medizinische Dokumentation gegeben werden, um die Informationsextraktion von PaDaWaN zu verbessern. Die Ergebnisse dieser Studie zeigen deutliche Diskrepanzen zwischen strukturierten und unstrukturierten Datenquellen. Vorhandene Register und Daten des CIS k{\"o}nnen zuk{\"u}nftig im Sinne einer internen Validierung verifiziert und damit manuelle Dokumentationsfehler nachhaltig aufgedeckt werden.}, subject = {datawarehousing}, language = {de} } @article{PorubskyPopovicBadveetal.2021, author = {Porubsky, Stefan and Popovic, Zoran V. and Badve, Sunil and Banz, Yara and Berezowska, Sabina and Borchert, Dietmar and Br{\"u}ggemann, Monika and Gaiser, Timo and Graeter, Thomas and Hollaus, Peter and Huettl, Katrin S. and Kotrova, Michaela and Kreft, Andreas and Kugler, Christian and L{\"o}tscher, Fabian and M{\"o}ller, Burkhard and Ott, German and Preissler, Gerhard and Roessner, Eric and Rosenwald, Andreas and Str{\"o}bel, Philipp and Marx, Alexander}, title = {Thymic hyperplasia with lymphoepithelial sialadenitis (LESA)-like features: strong association with lymphomas and non-myasthenic autoimmune diseases}, series = {Cancers}, volume = {13}, journal = {Cancers}, number = {2}, issn = {2072-6694}, doi = {10.3390/cancers13020315}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-223049}, year = {2021}, abstract = {Thymic hyperplasia (TH) with lymphoepithelial sialadenitis (LESA)-like features (LESA-like TH) has been described as a tumor-like, benign proliferation of thymic epithelial cells and lymphoid follicles. We aimed to determine the frequency of lymphoma and autoimmunity in LESA-like TH and performed retrospective analysis of cases with LESA-like TH and/or thymic MALT-lymphoma. Among 36 patients (21 males) with LESA-like TH (age 52 years, 32-80; lesion diameter 7.0 cm, 1-14.5; median, range), five (14\%) showed associated lymphomas, including four (11\%) thymic MALT lymphomas and one (3\%) diffuse large B-cell lymphoma. One additional case showed a clonal B-cell-receptor rearrangement without evidence of lymphoma. Twelve (33\%) patients (7 women) suffered from partially overlapping autoimmune diseases: systemic lupus erythematosus (n = 4, 11\%), rheumatoid arthritis (n = 3, 8\%), myasthenia gravis (n = 2, 6\%), asthma (n = 2, 6\%), scleroderma, Sj{\"o}gren syndrome, pure red cell aplasia, Grave's disease and anti-IgLON5 syndrome (each n = 1, 3\%). Among 11 primary thymic MALT lymphomas, remnants of LESA-like TH were found in two cases (18\%). In summary, LESA-like TH shows a striking association with autoimmunity and predisposes to lymphomas. Thus, a hematologic and rheumatologic workup should become standard in patients diagnosed with LESA-like TH. Radiologists and clinicians should be aware of LESA-like TH as a differential diagnosis for mediastinal mass lesions in patients with autoimmune diseases.}, language = {en} } @article{PaschkeLinckeMuelleretal.2015, author = {Paschke, Ralf and Lincke, Thomas and M{\"u}ller, Stefan P. and Kreissl, Michael C. and Dralle, Henning and Fassnacht, Martin}, title = {The Treatment of Well-Differentiated Thyroid Carcinoma}, series = {Deutsches {\"A}rzteblatt International}, volume = {112}, journal = {Deutsches {\"A}rzteblatt International}, doi = {10.3238/arztebl.2015.0452}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-151636}, pages = {452 -- 458}, year = {2015}, abstract = {Background: Recent decades have seen a rise in the incidence of well-differentiated (mainly papillary) thyroid carcinoma around the world. In Germany, the age-adjusted incidence of well-differentiated thyroid carcinoma in 2010 was 3.5 per 100 000 men and 8.7 per 100 000 women per year. Method: This review is based on randomized, controlled trials and multicenter trials on the treatment of well-differentiated thyroid carcinoma that were retrieved by a selective literature search, as well as on three updated guidelines issued in the past two years. Results: The recommended extent of surgical resection depends on whether the tumor is classified as low-risk or high-risk, so that papillary microcar cinomas, which carry a highly favorable prognosis, will not be overtreated. More than 90\% of localized, well-differentiated thyroid carcinomas can be cured with a combination of surgery and radioactive iodine therapy. Radio active iodine therapy is also effective in the treatment of well-differentiated thyroid carcinomas with distant metastases, yielding a 10-year survival rate of 90\%, as long as there is good iodine uptake and the tumor goes into remission after treatment; otherwise, the 10-year survival rate is only 10\%. In the past two years, better treatment options have become available for radioactive-iodine-resistant thyroid carcinoma. Phase 3 studies of two different tyrosine kinase inhibitors have shown that either one can markedly prolong progression-free survival, but not overall survival. Their more common clinically significant side effects are hand-foot syndrome, hypertension, diarrhea, proteinuria, and weight loss. Conclusion: Slow tumor growth, good resectability, and susceptibility to radioactive iodine therapy lend a favorable prognosis to most cases of well-differentiated thyroid carcinoma. The treatment should be risk-adjusted and interdisciplinary, in accordance with the current treatment guidelines. Even metastatic thyroid carcinoma has a favorable prognosis as long as there is good iodine uptake. The newly available medical treatment options for radioactive-iodine-resistant disease need to be further studied.}, language = {en} } @article{KelmGermerSchlegeletal.2021, author = {Kelm, Matthias and Germer, Christoph-Thomas and Schlegel, Nicolas and Flemming, Sven}, title = {The revival of surgery in Crohn's disease — early intestinal resection as a reasonable alternative in localized ileitis}, series = {Biomedicines}, volume = {9}, journal = {Biomedicines}, number = {10}, issn = {2227-9059}, doi = {10.3390/biomedicines9101317}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-246296}, year = {2021}, abstract = {Crohn's disease (CD) represents a heterogeneous and complex disease with no curative therapeutic option available to date. Current therapy is mainly antibody-based focusing on the immune system while other treatment alternatives such as surgery are considered to be "last options". However, medical therapy for CD results in mild to severe side effects in a relevant amount of patients and some patients do not respond to the medication. Following that, quality of life is often significantly reduced in this patient cohort, thus, therapeutic alternatives are urgently needed. Updated evidence has revealed that surgery such as ileocecal resection (ICR) might be a potential therapeutic option in case of localized terminal ileitis since resection at early time points improves quality of life and significantly reduces the postoperative need for immunosuppressive medication with low rates of morbidity. In addition, new surgical approaches such as Kono-S anastomosis or inclusion of the mesentery result in significantly reduced rates of disease recurrence and reoperation. Based on the new evidence, the goal of this review is to provide an update on the role of surgery as a reasonable alternative to medical therapy in the interdisciplinary treatment of patients with CD.}, language = {en} } @article{JakubietzJakubietzHorchetal.2019, author = {Jakubietz, Rafael G. and Jakubietz, Danni F. and Horch, Raymund E. and Gruenert, Joerg G. and Meffert, Rainer H. and Jakubietz, Michael G.}, title = {The microvascular peroneal artery perforator flap as a "lifeboat" for pedicled flaps}, series = {Plastic and Reconstructive Surgery - Global Open}, volume = {7}, journal = {Plastic and Reconstructive Surgery - Global Open}, number = {9}, doi = {10.1097/GOX.0000000000002396}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-202233}, pages = {e2396}, year = {2019}, abstract = {Background: Pedicled perforator flaps have expanded reconstructive options in extremity reconstruction. Despite preoperative mapping, intraoperative findings may require microvascular tissue transfer when no adequate perforators can be found. The free peroneal artery perforator flap may serve as a reliable back-up plan in small defects. Methods: In 16 patients with small soft tissue defects on the upper and lower extremities, perforator-based propeller flaps were planned. The handheld Doppler device was used to localize potential perforators for a propeller flap in close proximity to the defect. Perforators of the proximal peroneal artery were also marked to allow conversion to microvascular tissue transfer. Results: In 6 cases, no adequate perforators were found intraoperatively. In 4 patients, the peroneal artery perforator flap was harvested and transferred. The pedicle length did not exceed 4 cm. No flap loss occurred. Conclusions: When no adequate perforator capable of nourishing a propeller flap can be found intraoperatively, the free peroneal artery flap is a good option to reconstruct small soft tissue defects in the distal extremities. The short vascular pedicle is less ideal in cases with a large zone of injury requiring a more distant site of anastomosis or when recipient vessels are located in deeper tissue planes.}, language = {en} } @article{TecleHackenbergScheichetal.2023, author = {Tecle, Nyat-Eyob and Hackenberg, Stephan and Scheich, Matthias and Scherzad, Agmal and Hagen, Rudolf and Gehrke, Thomas}, title = {Surgical management of lateral neck abscesses in children: a retrospective analysis of 100 cases}, series = {European Journal of Pediatrics}, volume = {182}, journal = {European Journal of Pediatrics}, number = {1}, doi = {10.1007/s00431-022-04676-5}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-324179}, pages = {431-438}, year = {2023}, abstract = {Cervical abscesses are relatively common infections in pediatric patients. There is an ongoing debate about the necessity and time point of surgical drainage. The identification of a focus of infection might play an important role in facilitating a therapeutic decision. In a retrospective study, 100 pediatric patients aged 1-18 years who underwent incision and drainage of a lateral cervical abscess at our institution were analyzed. Patients were divided into two groups based on whether a focus of infection could be identified or not. Data collection included patient characteristics, microbiological results, antibiotic regimen, and clinical course. A focus of infection was found in 29\% (29/100) of the patients, most frequently in the tonsils. A causative microorganism was found in 75\% (75/100) of all patients, with Staphylococcus aureus and Streptococcus pyogenes being the most common pathogens. All patients received an empiric antibiotic therapy in addition to surgery. Antibiotic medication was changed in 31\% in both groups (9/29 with a focus of infection and 22/71 without a focus of infection) during therapy. Children without an identified focus of infection generally were younger and had more comorbidities reducing immune response while also showing differences in the pathogens involved. There were no complications associated to surgery or antibiotic therapy in any of the patients involved. Conclusion: Children with an identified focus of infection show several differences compared to those with isolated lateral abscesses, especially regarding the microorganisms involved. But the focus of infection seems not to have an impact on patient's outcome. What is Known: • Neck abscesses are a relatively common disease in the pediatric population and may cause serious complications. • Therapy in general consists of intravenous antibiotics with or without surgery. What is New: • The focus identification has no impact on patient's outcome. • Children with an identified focus of infection show several differences compared to those with isolated lateral abscesses, especially regarding their medical history, age, and the microorganisms involved.}, language = {en} } @article{ElMajdoubHunscheIgressaetal.2015, author = {El Majdoub, Faycal and Hunsche, Stefan and Igressa, Alhadi and Kocher, Martin and Sturm, Volker and Maarouf, Mohammad}, title = {Stereotactic LINAC-Radiosurgery for Glomus Jugulare Tumors: A Long-Term Follow-Up of 27 Patients}, series = {PLoS ONE}, volume = {10}, journal = {PLoS ONE}, number = {6}, doi = {10.1371/journal.pone.0129057}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-151717}, pages = {e0129057}, year = {2015}, abstract = {Background The optimal treatment of glomus jugulare tumors (GJTs) remains controversial. Due to the critical location, microsurgery still provides high treatment-related morbidity and a decreased quality of life. Thus, we performed stereotactical radiosurgery (SRS) for the treatment of GJTs and evaluated the long-term outcome. Methods Between 1991 and 2011, 32 patients with GJTs underwent SRS using a linear accelerator (LINAC) either as primary or salvage therapy. Twenty-seven patients (median age 59.9 years, range 28.7-79.9 years) with a follow-up greater than five years (median 11 years, range 5.3-22.1 years) were selected for retrospective analysis. The median therapeutic single dose applied to the tumor surface was 15 Gy (range 11-20 Gy) and the median tumor volume was 9.5 ml (range 2.8-51 ml). Results Following LINAC-SRS, 10 of 27 patients showed a significant improvement of their previous neurological complaints, whereas 12 patients remained unchanged. Five patients died during follow-up due to old age or other, not treatment-related reasons. MR-imaging showed a partial remission in 12 and a stable disease in 15 patients. No tumor progression was observed. The actuarial overall survival rates after five, ten and 20 years were 100\%, 95.2\% and 79.4\%, respectively. Conclusions Stereotactic LINAC-Radiosurgery can achieve an excellent long-term tumor control beside a low rate of morbidity in the treatment of GJTs. It should be considered as an alternative therapy regime to surgical resection or fractionated external beam radiation either as primary, adjuvant or salvage therapy.}, language = {en} } @phdthesis{Wennmann2021, author = {Wennmann, Andreas}, title = {Retrospektiver Vergleich der pr{\"a}operativen Lokalisationsdiagnostik mit der intraoperativen Detektion von Nebenschilddr{\"u}sen-Adenomen sowie dem perioperativen Verlauf bei Patienten/Patientinnen mit prim{\"a}rem Hyperparathyreoidismus}, doi = {10.25972/OPUS-24989}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-249895}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {Die Exstirpation erkrankter Nebenschilddr{\"u}sen (NSD) ist die einzige kurative Therapie des prim{\"a}ren Hyperparathyreoidismus (pHPT). Die pr{\"a}operative Detektion der dem pHPT zugrunde liegenden NSD-Adenome durch eine ad{\"a}quate Lokalisationsdiagnostik stellt eine wichtige S{\"a}ule bei der Operationsplanung dar. Angesichts der umfangreichen diagnostischen M{\"o}glichkeiten ist noch nicht abschließend beantwortet, wie viel und welche Diagnostik mit hoher Wahrscheinlichkeit zur erfolgreichen Lokalisation von NSD-Adenomen f{\"u}hrt und ob/wie diese den perioperativen Verlauf beeinflusst. Die Beantwortung dieser Fragen war das Hauptziel der vorliegenden Arbeit. Es handelt sich um eine monozentrische, retrospektive Datenanalyse anhand des Kollektivs des Universit{\"a}tsklinikums W{\"u}rzburg (UKW) der Jahre 2005 bis 2017. Nach Datenextraktion aller Patienten/Patientinnen mit Hyperparathyreoidismus aus dem Dokumentationssystem des UKW erfolgten die deskriptiven und statistischen Auswertungen mittels Excel und SPSS. Insgesamt wurden im untersuchten Zeitraum 467 Patienten/Patientinnen aufgrund eines pHPT operiert. NSD-Sono und NSD-Szinti waren die am h{\"a}ufigsten durchgef{\"u}hrten Lokalisationsdiagnostika mit Sensitivit{\"a}ten von 61,5 \% bzw. 66,3 \% f{\"u}r die Seite. Bei der Etagen-Blutentnahme lag die Sensitivit{\"a}t bei 100 \%; bei der MRT bei 47,4 \% und bei der 11Kohlenstoff-Methionin-Positronenemissionstomographie/Computertomographie (11C-Methionin-PET/CT) bei 58,8 \%. Durch zus{\"a}tzliche Diagnostik konnte nicht grunds{\"a}tzlich eine Erh{\"o}hung der Treffsicherheit erreicht werden. Die Analyse der perioperativen Parameter zeigte, dass das Alter der Operierten positiv mit der Operationsdauer, der Krankenhausaufenthaltsdauer und dem Auftreten postoperativer Hypocalc{\"a}mien korrelierte. Die Einnahme eines Thrombozytenaggregationshemmers f{\"u}hrte zu einer verl{\"a}ngerten Krankenhausaufenthaltsdauer. Die therapeutische Antikoagulation war ein Risikofaktor in Bezug auf l{\"a}ngere OP-Dauern und das Auftreten von Nachblutungen. Eine zus{\"a}tzlich zur Parathyreoidektomie durchgef{\"u}hrte Sanierung der Schilddr{\"u}se war mit einer erh{\"o}hten Rate an postoperativen Hypocalc{\"a}mien vergesellschaftet. Zusammenfassend zeigen die vorliegenden Daten, dass nach initial vermeintlich erfolgreicher Detektion eines NSD-Adenoms mit NSD-Sono oder NSD-Szinti eine weiterf{\"u}hrende Lokalisationsdiagnostik nicht sinnvoll ist. Nach initial erfolgloser NSD-Sono oder NSD-Szinti dagegen ist die Durchf{\"u}hrung einer 11C-Methionin-PET/CT zu erw{\"a}gen.}, subject = {Prim{\"a}rer Hyperparathyreoidismus}, language = {de} } @article{StanglPoppReisetal.2024, author = {Stangl, Stephanie and Popp, Maria and Reis, Stefanie and Sitter, Magdalena and Saal-Bauernschubert, Lena and Schießer, Selina and Kranke, Peter and Choorapoikayil, Suma and Weibel, Stephanie and Meybohm, Patrick}, title = {Reported outcomes in patients with iron deficiency or iron deficiency anemia undergoing major surgery: a systematic review of outcomes}, series = {Systematic Reviews}, volume = {13}, journal = {Systematic Reviews}, doi = {10.1186/s13643-023-02431-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-357213}, year = {2024}, abstract = {Background Iron deficiency (ID) is the leading cause of anemia worldwide. The prevalence of preoperative ID ranges from 23 to 33\%. Preoperative anemia is associated with worse outcomes, making it important to diagnose and treat ID before elective surgery. Several studies indicated the effectiveness of intravenous iron supplementation in iron deficiency with or without anemia (ID(A)). However, it remains challenging to establish reliable evidence due to heterogeneity in utilized study outcomes. The development of a core outcome set (COS) can help to reduce this heterogeneity by proposing a minimal set of meaningful and standardized outcomes. The aim of our systematic review was to identify and assess outcomes reported in randomized controlled trials (RCTs) and observational studies investigating iron supplementation in iron-deficient patients with or without anemia. Methods We searched MEDLINE, CENTRAL, and ClinicalTrials.gov systematically from 2000 to April 1, 2022. RCTs and observational studies investigating iron supplementation in patients with a preoperative diagnosis of ID(A), were included. Study characteristics and reported outcomes were extracted. Outcomes were categorized according to an established outcome taxonomy. Quality of outcome reporting was assessed with a pre-specified tool. Reported clinically relevant differences for sample size calculation were extracted. Results Out of 2898 records, 346 underwent full-text screening and 13 studies (five RCTs, eight observational studies) with sufficient diagnostic inclusion criteria for iron deficiency with or without anemia (ID(A)) were eligible. It is noteworthy to mention that 49 studies were excluded due to no confirmed diagnosis of ID(A). Overall, 111 outcomes were structured into five core areas including nine domains. Most studies (92\%) reported outcomes within the 'blood and lymphatic system' domain, followed by "adverse event" (77\%) and "need for further resources" (77\%). All of the latter reported on the need for blood transfusion. Reported outcomes were heterogeneous in measures and timing. Merely, two (33\%) of six prospective studies were registered prospectively of which one (17\%) showed no signs of selective outcome reporting. Conclusion This systematic review comprehensively depicts the heterogeneity of reported outcomes in studies investigating iron supplementation in ID(A) patients regarding exact definitions and timing. Our analysis provides a systematic base for consenting to a minimal COS. Systematic review registration PROSPERO CRD42020214247}, language = {en} } @article{AltieriLaSalviaModicaetal.2023, author = {Altieri, Barbara and La Salvia, Anna and Modica, Roberta and Marciello, Francesca and Mercier, Olaf and Filosso, Pier Luigi and de Latour, Bertrand Richard and Giuffrida, Dario and Campione, Severo and Guggino, Gianluca and Fadel, Elie and Papotti, Mauro and Colao, Annamaria and Scoazec, Jean-Yves and Baudin, Eric and Faggiano, Antongiulio}, title = {Recurrence-free survival in early and locally advanced large cell neuroendocrine carcinoma of the lung after complete tumor resection}, series = {Journal of Personalized Medicine}, volume = {13}, journal = {Journal of Personalized Medicine}, number = {2}, issn = {2075-4426}, doi = {10.3390/jpm13020330}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-304000}, year = {2023}, abstract = {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.}, language = {en} }