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PeerJ. 2019 Mar 27;7:e6539. doi: 10.7717/peerj.6539. eCollection 2019.

Clinicopathological characteristics, treatment and survival of pulmonary large cell neuroendocrine carcinoma: a SEER population-based study.

Author information

1
Department of Radiation Oncology, Cancer Hospital of Jilin Province, Changchun, Jilin, China.
2
Department of Anesthesiology, First Hospital of Jilin University, Changchun, Jilin, China.
3
Department of Pathology, Cancer Hospital of Jilin Province, Changchun, Jilin, China.
4
Department of Medical Oncology, Cancer Hospital of Jilin Province, Changchun, Jilin, China.
5
Department of Thoracic Surgery, First Hospital of Jilin University, Changchun, Jilin, China.
#
Contributed equally

Abstract

Background:

This study was designed to investigate the clinicopathological characteristics, treatment and survival of patients with pulmonary large cell neuroendocrine carcinoma (LCNEC).

Methods:

The Surveillance, Epidemiology and End Results database was utilized to identify patients diagnosed with pulmonary LCNEC between 2004 and 2013. Kaplan-Meier analysis was conducted to determine the overall survival (OS) and cancer-specific survival (CSS) rate. Univariate survival analysis along with log-rank test, and Cox proportional hazards model were employed to detect independent prognostic factors.

Results:

Pulmonary LCNEC accounted for 0.58% (2972/510607) of the total number of lung and bronchus carcinoma. And a total of 1,530 eligible cases were identified, with the median follow-up time of 11 months. To be specific, the 3-, 5-year OS and CSS rates were 22.8%, 16.8% and 26.5%, 20.8% respectively. Generally, pulmonary LCNEC was commonly detected in the elderly (72.2%), males (55.9%), the upper lobe (62.0%) and advanced AJCC stage (65.5%). Multivariate analysis revealed that elderly [(≥60 and <80 years) HR:1.203, 95% CI [1.053-1.375], P = 0.007; (≥80 years) HR:1.530, 95% CI [1.238-1.891], P < 0.001] and advanced AJCC stage [(stage III) HR:2.606, 95% CI [2.083-3.260], P < 0.001; (stage IV) HR:4.881, 95% CI [3.923-6.072], P < 0.001] were independent unfavorable prognostic factors, and that female (HR:0.845, 95% CI [0.754-0.947], P = 0.004)), surgery [(Segmentectomy/wedge resection) HR:0.526, 95% CI [0.413-0.669], P < 0.001; (Lobectomy/Bilobectomy) HR:0.357, 95% CI [0.290-0.440], P < 0.001;(Pneumonectomy) HR:0.491, 95% CI [0.355-0.679], P < 0.001] , chemotherapy (HR:0.442, 95% CI [0.389-0.503], P < 0.001) and radiation (HR:0.837, 95% CI [0.738-0.949], P = 0.005) were independent favorable prognostic factors.

Conclusion:

To sum up, age at diagnosis, sex, AJCC 8th edition stage, surgery, chemotherapy and radiation were significantly associated with OS of patients with pulmonary LCNEC.

KEYWORDS:

Overall survival; Prognosis; Pulmonary large cell neuroendocrine carcinoma; SEER

Conflict of interest statement

The authors declare that they have no competing interests.

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