Skip to main content
Top
Published in: World Journal of Surgery 7/2017

01-07-2017 | Original Scientific Report

Outcomes of Curative-Intent Surgery and Adjuvant Treatment for Pulmonary Large Cell Neuroendocrine Carcinoma

Authors: Kun Woo Kim, Hong Kwan Kim, Jhingook Kim, Young Mog Shim, Myung-Ju Ahn, Yoon-La Choi

Published in: World Journal of Surgery | Issue 7/2017

Login to get access

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.
Literature
1.
go back to reference Travis WD (2010) Advances in neuroendocrine lung tumors. Ann Oncol 7:65–71 Travis WD (2010) Advances in neuroendocrine lung tumors. Ann Oncol 7:65–71
2.
go back to reference Asamura H, Kameya T, MAtsuno Y et al (2006) Neuroendocrine neoplasms of the lung: a prognostic spectrum. J Clin Oncol 24:70–76CrossRefPubMed Asamura H, Kameya T, MAtsuno Y et al (2006) Neuroendocrine neoplasms of the lung: a prognostic spectrum. J Clin Oncol 24:70–76CrossRefPubMed
3.
go back to reference Fernandez FG, Battafarano RJ (2006) Large-cell neuroendocrine carcinoma of the lung. Cancer Control 13:270–275PubMed Fernandez FG, Battafarano RJ (2006) Large-cell neuroendocrine carcinoma of the lung. Cancer Control 13:270–275PubMed
4.
go back to reference Iyoda A, Jiang SX, Travis WD et al (2013) Clinicopathological features and the impact of the new TNM classification of malignant tumors in patients with pulmonary large cell neuroendocrine carcinoma. Mol Clin Oncol 1:437–443PubMedPubMedCentral Iyoda A, Jiang SX, Travis WD et al (2013) Clinicopathological features and the impact of the new TNM classification of malignant tumors in patients with pulmonary large cell neuroendocrine carcinoma. Mol Clin Oncol 1:437–443PubMedPubMedCentral
5.
go back to reference Gollard R, Jhatakia S, Elliott M et al (2010) Large cell/neuroendocrine carcinoma. Lung Cancer 69:13–18CrossRefPubMed Gollard R, Jhatakia S, Elliott M et al (2010) Large cell/neuroendocrine carcinoma. Lung Cancer 69:13–18CrossRefPubMed
6.
go back to reference Battafarano RJ, Fernandez FG, Ritter J et al (2005) Large cell neuroendocrine carcinoma: an aggressive form of non-small cell lung cancer. J Thorac Cardiovasc Surg 130:166–172CrossRefPubMed Battafarano RJ, Fernandez FG, Ritter J et al (2005) Large cell neuroendocrine carcinoma: an aggressive form of non-small cell lung cancer. J Thorac Cardiovasc Surg 130:166–172CrossRefPubMed
7.
go back to reference Doddoli C, Barlesi F, Chetaille B et al (2004) Large cell neuroendocrine carcinoma of the lung: an aggressive disease potentially treatable with surgery. Ann Thorac Surg 77:1168–1172CrossRefPubMed Doddoli C, Barlesi F, Chetaille B et al (2004) Large cell neuroendocrine carcinoma of the lung: an aggressive disease potentially treatable with surgery. Ann Thorac Surg 77:1168–1172CrossRefPubMed
8.
go back to reference Iyoda A, Hiroshima K, Nakatani Y et al (2007) Pulmonary large cell neuroendocrine carcinoma: its place in the spectrum of pulmonary carcinoma. Ann Thorac Surg 84:702–707CrossRefPubMed Iyoda A, Hiroshima K, Nakatani Y et al (2007) Pulmonary large cell neuroendocrine carcinoma: its place in the spectrum of pulmonary carcinoma. Ann Thorac Surg 84:702–707CrossRefPubMed
9.
go back to reference Kumar P, Herndon J 2nd, Langer M et al (1996) Pattern of disease failure after trimodality therapy of nonsmall cell lung carcinoma pathologic stage IIIA (N2). Analysis of Cancer and Leukemia Group B Protocol 8935. Cancer 77:2393–2399CrossRefPubMed Kumar P, Herndon J 2nd, Langer M et al (1996) Pattern of disease failure after trimodality therapy of nonsmall cell lung carcinoma pathologic stage IIIA (N2). Analysis of Cancer and Leukemia Group B Protocol 8935. Cancer 77:2393–2399CrossRefPubMed
10.
go back to reference Williams CD, Gajra A, Ganti AK et al (2014) Use and impact of adjuvant chemotherapy in patients with resected non-small cell lung cancer. Cancer 120:1939–1947CrossRefPubMed Williams CD, Gajra A, Ganti AK et al (2014) Use and impact of adjuvant chemotherapy in patients with resected non-small cell lung cancer. Cancer 120:1939–1947CrossRefPubMed
11.
go back to reference Howington JA, Blum MG, Chang AC et al (2013) Treatment of stage I and II non-small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 143:278–313CrossRef Howington JA, Blum MG, Chang AC et al (2013) Treatment of stage I and II non-small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 143:278–313CrossRef
12.
go back to reference Saji H, Tsuboi M, Matsubayashi J et al (2010) Clinical response of large cell neuroendocrine carcinoma of the lung to perioperative adjuvant chemotherapy. Anticancer Drugs 21:89–93CrossRefPubMed Saji H, Tsuboi M, Matsubayashi J et al (2010) Clinical response of large cell neuroendocrine carcinoma of the lung to perioperative adjuvant chemotherapy. Anticancer Drugs 21:89–93CrossRefPubMed
13.
go back to reference Sarkaria IS, Iyoda A, Roh MS et al (2011) Neoadjuvant and adjuvant chemotherapy in resected pulmonary large cell neuroendocrine carcinoma: a single institution experience. Ann Thorac Surg 92:1180–1186CrossRefPubMed Sarkaria IS, Iyoda A, Roh MS et al (2011) Neoadjuvant and adjuvant chemotherapy in resected pulmonary large cell neuroendocrine carcinoma: a single institution experience. Ann Thorac Surg 92:1180–1186CrossRefPubMed
14.
go back to reference Travis WD, Brambilla E, Müller-Hermelink HK et al (2004) Pathology and genetics: tumors of the lung, pleura, thymus and heart. IARC, Lyon Travis WD, Brambilla E, Müller-Hermelink HK et al (2004) Pathology and genetics: tumors of the lung, pleura, thymus and heart. IARC, Lyon
15.
go back to reference Edge S, Byrd DR, Compton CC et al (2009) AJCC cancer staging manual, 7th edn. Springer, New York Edge S, Byrd DR, Compton CC et al (2009) AJCC cancer staging manual, 7th edn. Springer, New York
16.
go back to reference Paci M, Cavazza A, Annessi V et al (2004) Large cell neuroendocrine carcinoma of the lung: a 10-year clinicopathologic retrospective study. Ann Thorac Surg 77:1163–1167CrossRefPubMed Paci M, Cavazza A, Annessi V et al (2004) Large cell neuroendocrine carcinoma of the lung: a 10-year clinicopathologic retrospective study. Ann Thorac Surg 77:1163–1167CrossRefPubMed
17.
go back to reference Veronesi G, Morandi U, Alloisio M et al (2006) Large cell neuroendocrine carcinoma of the lung: a retrospective analysis of 144 surgical cases. Lung Cancer 53:111–115CrossRefPubMed Veronesi G, Morandi U, Alloisio M et al (2006) Large cell neuroendocrine carcinoma of the lung: a retrospective analysis of 144 surgical cases. Lung Cancer 53:111–115CrossRefPubMed
18.
go back to reference Iyoda A, Hiroshima K, Moriya Y et al (2009) Postoperative recurrence and the role of adjuvant chemotherapy in patients with pulmonary large-cell neuroendocrine carcinoma. J Thorac Cardiovasc Surg 138:446–453CrossRefPubMed Iyoda A, Hiroshima K, Moriya Y et al (2009) Postoperative recurrence and the role of adjuvant chemotherapy in patients with pulmonary large-cell neuroendocrine carcinoma. J Thorac Cardiovasc Surg 138:446–453CrossRefPubMed
19.
go back to reference Iyoda A, Hiroshima K, Moriya Y et al (2006) Prognostic impact of large cell neuroendocrine histology in patients with pathologic stage Ia pulmonary non small cell carcinoma. J Thorac Cardiovasc Surg 132:312–315CrossRefPubMed Iyoda A, Hiroshima K, Moriya Y et al (2006) Prognostic impact of large cell neuroendocrine histology in patients with pathologic stage Ia pulmonary non small cell carcinoma. J Thorac Cardiovasc Surg 132:312–315CrossRefPubMed
20.
go back to reference Dresler CM, Ritter JH, Patterson GA et al (1997) Clinical-pathologic analysis of 40 patients with large cell neuroendocrine carcinoma of the lung. Ann Thorac Surg 63:180–185CrossRefPubMed Dresler CM, Ritter JH, Patterson GA et al (1997) Clinical-pathologic analysis of 40 patients with large cell neuroendocrine carcinoma of the lung. Ann Thorac Surg 63:180–185CrossRefPubMed
21.
go back to reference Douillard JY, Rosell R, De Lena M et al (2006) Adjuvant vinorelbine plus cisplatin versus observation in patients with completely resected stage IB–IIIA non-small-cell lung cancer(Adjuvant Navelbine International Trialist Association[ANITA]): a randomized controlled trial. Lancet Oncol 7:719–727CrossRefPubMed Douillard JY, Rosell R, De Lena M et al (2006) Adjuvant vinorelbine plus cisplatin versus observation in patients with completely resected stage IB–IIIA non-small-cell lung cancer(Adjuvant Navelbine International Trialist Association[ANITA]): a randomized controlled trial. Lancet Oncol 7:719–727CrossRefPubMed
22.
go back to reference Butts CA, Ding K, Seymour L et al (2010) Randomized phase III trial of vinorelbine plus cisplatin compared with observation in completely resected stage IB and II non-small-cell lung cancer: updated survival analysis of JBR-10. J Clin Oncol 28:29–34CrossRefPubMed Butts CA, Ding K, Seymour L et al (2010) Randomized phase III trial of vinorelbine plus cisplatin compared with observation in completely resected stage IB and II non-small-cell lung cancer: updated survival analysis of JBR-10. J Clin Oncol 28:29–34CrossRefPubMed
23.
go back to reference Ettinger DS, Akerley W, Borghaei H et al (2013) Non-small cell lung cancer, version2. 2013. J Natl Compr Canc Netw 11:645–653CrossRefPubMed Ettinger DS, Akerley W, Borghaei H et al (2013) Non-small cell lung cancer, version2. 2013. J Natl Compr Canc Netw 11:645–653CrossRefPubMed
24.
go back to reference Roesel C, Terjung S, Weinreich G et al (2016) A single-institution analysis of the surgical management of pulmonary large cell neuroendocrine carcinomas. Ann Thorac Surg 101:1909–1914CrossRef Roesel C, Terjung S, Weinreich G et al (2016) A single-institution analysis of the surgical management of pulmonary large cell neuroendocrine carcinomas. Ann Thorac Surg 101:1909–1914CrossRef
Metadata
Title
Outcomes of Curative-Intent Surgery and Adjuvant Treatment for Pulmonary Large Cell Neuroendocrine Carcinoma
Authors
Kun Woo Kim
Hong Kwan Kim
Jhingook Kim
Young Mog Shim
Myung-Ju Ahn
Yoon-La Choi
Publication date
01-07-2017
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 7/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-017-3908-8

Other articles of this Issue 7/2017

World Journal of Surgery 7/2017 Go to the issue

Surgical Symposium Contribution

Evaluation of Gastroesophageal Reflux Disease