scholarly journals Stereotactic ablative body radiotherapy versus conventionally fractionated radiotherapy for early stage large cell neuroendocrine carcinoma of the lung

2020 ◽  
Vol 9 (3) ◽  
pp. LMT32
Author(s):  
Rodney E Wegner ◽  
Stephen Abel ◽  
Athanasios Colonias
Keyword(s):  
Neuroendocrine Carcinoma ◽  
Cox Regression ◽  
Early Stage ◽  
Large Cell ◽  
Large Cell Neuroendocrine Carcinoma ◽  
National Cancer Database ◽  
Fractionated Radiotherapy ◽  
Academic Center ◽  
Stereotactic Ablative Body Radiotherapy ◽  
Propensity Matching

Aim: Some patients with early stage large cell neuroendocrine carcinoma (LCNEC) of the lung are not surgical candidates and will be managed with radiotherapy. We used the national cancer database to identify predictors of stereotactic radiotherapy and compare outcomes. Materials & methods: We queried national cancer database for T1-2N0 LCNEC treated with radiation. Logistic regression and Cox regression identified predictors of stereotactic ablative body radiotherapy (SABR) and survival, respectively. Results: We identified 754 patients, with 238 (32%) treated with SABR. Predictors of SABR were distance to facility, no chemotherapy, academic center, T1 and recent year. After propensity matching, median survival was 34.7 months compared with 23.7 months in favor of SABR (p = 0.02). Conclusion: SABR for LCNEC has increased over time and was associated with improved survival.

scholarly journals CDX2 Expression and Prognostic Factors of Resectable Pulmonary Large Cell Neuroendocrine Carcinoma

2020 ◽  
Vol 14 ◽  
pp. 117955492096731
Author(s):  
Ryo Mori ◽  
Shin-ichi Yamashita ◽  
Kensuke Midorikawa ◽  
Sosei Abe ◽  
Kazuo Inada ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Adjuvant Chemotherapy ◽  
Prognostic Factor ◽  
Neuroendocrine Carcinoma ◽  
Vascular Invasion ◽  
Cox Regression ◽  
Large Cell ◽  
Large Cell Neuroendocrine Carcinoma ◽  
Clinicopathological Factors ◽  
Cdx2 Expression

Background and Aim: Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare neoplasm, and its clinical features and management are still limited. We evaluated the clinicopathological factors, including CDX2 immunohistochemical expression, to predict survival in patients with LCNEC. Patients and Methods: In all, 50 patients with LCNEC who underwent surgery at 4 institutes between 2001 and 2017 were included. Clinicopathological characteristics were evaluated for prognostic factors and statistically analyzed by Kaplan-Meier curve with a log-rank test or Cox regression models. We used immunohistochemical (IHC) analysis to determine the expressions of CDX2 and compared them with clinicopathological factors and survival. Results: Sixteen of the 50 cases (32%) were CDX2 positive. No correlation was found between the CDX2 expression by IHC and clinicopathological factors. Multivariate analysis identified adjuvant chemotherapy (hazard ratio [HR] =2.86, 95% confidence interval [CI] = 1.04-8.16, P = .04) and vascular invasion (HR = 4.35, 95% CI = 1.21-15.63, P = .03) as being associated with a significantly worse rate of recurrence-free survival. Conclusion: CDX2 was expressed in 1/3 of LCNEC but not associated with prognostic factor. Adjuvant chemotherapy and vascular invasion were associated with a negative prognostic factor of LCNEC.

scholarly journals Clinical features of large cell neuroendocrine carcinoma: a population-based overview

2015 ◽  
Vol 47 (2) ◽  
pp. 615-624 ◽  
Author(s):  
Jules L. Derks ◽  
Lizza E. Hendriks ◽  
Wieneke A. Buikhuisen ◽  
Harry J.M. Groen ◽  
Erik Thunnissen ◽  
...  
Keyword(s):  
The Netherlands ◽  
Cancer Registry ◽  
Neuroendocrine Carcinoma ◽  
Early Stage ◽  
Small Cell Lung Carcinoma ◽  
Large Cell ◽  
Large Cell Neuroendocrine Carcinoma ◽  
Stage I ◽  
Cell Lung Carcinoma ◽  
Netherlands Cancer Registry

Pulmonary large cell neuroendocrine carcinoma (LCNEC) is an orphan disease and few data are available on its clinical characteristics. Therefore, we analysed LCNEC registered in the Netherlands Cancer Registry, and compared data with small cell lung carcinoma (SCLC), squamous cell carcinoma (SqCC) and adenocarcinoma (AdC).Histologically confirmed LCNEC (n=952), SCLC (n=11 844), SqCC (n=19 633) and AdC (n=24 253) cases were selected from the Netherlands Cancer Registry (2003–2012). Patient characteristics, metastasis at diagnosis (2006 or later), overall survival (OS) including multivariate Cox models and first-line treatment were compared for stage I–II, III and IV disease.The number of LCNEC cases increased from 56 patients in 2003 to 143 in 2012, accounting for 0.9% of all lung cancers. Stage IV LCNEC patients (n=383) commonly had metastasis in the liver (47%), bone (32%) and brain (23%), resembling SCLC. Median OS (95% CI) of stage I–II, III and IV LCNEC patients was 32.4 (22.0–42.9), 12.6 (10.3–15.0) and 4.0 (3.5–4.6) months, respectively. Multivariate-adjusted OS of LCNEC patients resembled that of SCLC patients, and was poorer than those of SqCC and AdC patients. However, frequency of surgical resection and adjuvant chemotherapy resembled SqCC and AdC more than SCLC.Diagnosis of LCNEC has increased in recent years. The metastatic pattern of LCNEC resembles SCLC as does the OS. However, early-stage treatment strategies seem more comparable to those of SqCC and AdC.

scholarly journals Pure Large Cell Neuroendocrine Carcinoma of Ovary: A Rare Clinical Entity and Review of Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
P. N. Shakuntala ◽  
K. Uma Devi ◽  
K. Shobha ◽  
U. D. Bafna ◽  
M. Geetashree
Keyword(s):  
Neuroendocrine Carcinoma ◽  
Neuroendocrine Tumour ◽  
Early Stage ◽  
Intraepithelial Neoplasia ◽  
Large Cell ◽  
Large Cell Neuroendocrine Carcinoma ◽  
World Health ◽  
Type I ◽  
Cervical Intraepithelial Neoplasia Grade ◽  
Large Tumor

Large cell neuroendocrine carcinoma (LCNEC) of the ovary is a rare tumor and is now included in the World Health Organization tumor classification. Its prognosis is generally very poor even when the diagnosis is made at an early stage. We report a case of pure large cell neuroendocrine tumour of ovary, appearing 9 months following laparoscopic type I hysterectomy, bilateral pelvic lymph node dissection with ovarian preservation of anatomically normal looking ovaries performed for a cervical biopsy diagnosis of cervical intraepithelial neoplasia grade III with foci of invasion. The rarity lies in the rapid onset (9 months) of a large tumor following conservation of an anatomically normal ovaries. Surgical debulking and five cycles of chemotherapy (Etoposide and Cisplatin) were administered to the woman. She is on followup with no clinical or radiological evidence of disease recurrence for 6 months.

scholarly journals Construction of a nomogram to predict overall survival for patients with lung large cell neuroendocrine carcinoma: analysis of the SEER database

2020 ◽  
Author(s):  
Dong Han ◽  
Fei Gao ◽  
Nan Li ◽  
Hao Wang ◽  
Qi Fu
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Neuroendocrine Carcinoma ◽  
Cox Regression ◽  
Risk Group ◽  
Multivariable Analysis ◽  
Large Cell ◽  
Large Cell Neuroendocrine Carcinoma ◽  
Seer Database ◽  
Cox Regression Analysis

Abstract Background Lung large cell neuroendocrine carcinoma (L-LCNEC) has a poor prognosis with lower survival rate than other NSCLC patients. The estimation of an individual survival rate is puzzling. The main purpose of this study was to establish a more accurate model to predict the prognosis of L-LCNEC.Methods Patients aged 18 years or older with L-LCNEC were identified from the Surveillance, Epidemiology and End Results (SEER) database from 2004 to 2015. Cox regression analysis was used to identify factors associated with survival time. The results were used to construct a nomogram to predict 1-year, and 3-year survival probability in L-LCNEC patients. Overall survival (OS) were compared between low risk group and high risk group by the Kaplan–Meier analysis.Results A total of 3216 patients were included in the study. We randomly divided all included patients into 7:3 training and validating groups. In multivariable analysis of training cohort, age at diagnosis, sex, stage of tumor, surgical treatment, radiotherapy and chemotherapy were independent prognostic factors for OS. All these factors were incorporated to construct a nomogram, which was tested in the validating cohort.Conclusions we constructed a visual nomogram prognosis model, which had the potential to predict the 1-year and 3-year survival rate of L-LCNEC patients, and could be used as an assistant prediction tool in clinical practice.

Nomogram to predict survival of pulmonary large-cell neuroendocrine carcinoma after surgery

2020 ◽  
Author(s):  
Qian Huang ◽  
Jie Liu ◽  
Huifang Cai ◽  
Qi Zhang ◽  
Lina Wang
Keyword(s):  
Overall Survival ◽  
Regression Analysis ◽  
Prognostic Factors ◽  
Neuroendocrine Carcinoma ◽  
Cox Regression ◽  
Predictive Performance ◽  
Large Cell ◽  
Large Cell Neuroendocrine Carcinoma ◽  
Operating Characteristics ◽  
Cox Regression Analysis

Abstract Background Pulmonary large-cell neuroendocrine carcinoma (LCNEC) is a rare primary malignant tumor with a poor prognosis, and surgery is the main treatment. However, there are no effective predictive tools to assess the prognosis of postoperative patients. Our aim is to identify prognostic factors and construct nomogram to accurately assess prognosis. Methods Patients were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Based on the results of Cox regression analysis, construct nomogram for predicting 1-, 3-, and 5-year survival. The predictive performance of nomogram was evaluated using the consistency index (C-index), the area under the receiver operating characteristics curve (AUC), and calibration plots. Results We finally screened 903 patients with pulmonary LCNEC who underwent surgery. The Cox regression analysis showed that age, SEER stage, T stage, N stage, M stage, tumor size, and chemotherapy were independent prognostic factors for overall survival (P<0.05). The C-index of the nomogram is 0.681 on the training cohort and 0.675 on the validation cohort. The AUC and calibration plots show that the nomogram has good performance. Conclusion We constructed and validated nomogram for predicting 1-, 3-, and 5-year survival of patients with pulmonary LCNEC after surgery. Our nomogram provides reference information for assessing the overall survival of these patients.

scholarly journals A Population-Based Systematic Clinical Analysis With a Single-Center Case Series of Patients With Pulmonary Large Cell Neuroendocrine Carcinoma

2021 ◽  
Vol 12 ◽  
Author(s):  
Xu Sun ◽  
Yijun Wu ◽  
Jing Shen ◽  
Chang Han ◽  
Kai Kang ◽  
...  
Keyword(s):  
Neuroendocrine Carcinoma ◽  
Cox Regression ◽  
Case Series ◽  
Large Cell ◽  
Mortality Rates ◽  
Population Based ◽  
Large Cell Neuroendocrine Carcinoma ◽  
Rank Test ◽  
Seer Database ◽  
Incidence And Mortality

Background and ObjectivesThis study aims to conduct an updated systematic analysis of patients with pulmonary large cell neuroendocrine carcinoma (PLCNC) in recent decades, concerning incidence and mortality trends, demographics, treatments, survival and death causes.MethodsPatients who were diagnosed with PLCNC at the Peking Union Medical College Hospital (PUMCH) between 2000 to 2020 were retrospectively analyzed. The population-based Surveillance, Epidemiology, and End Results (SEER) database were also retrieved. Frequencies and average annual age-adjusted rates (AAR) of PLCNC patients were calculated and analyzed by Joint-point regression. Univariate and multivariate Cox regression were used for identifying prognostic factors. Predictive nomograms for overall survival (OS) and cancer-specific survival (CSS) were developed and then validated by calculating C-index values and drawing calibration curves. Survival curves were plotted using the Kaplan-Meier method and compared by log-rank test. Causes of death were also analyzed by time latency.ResultsA total of 56 PLCNC patients of the PUMCH cohort were included. Additionally, the PLCNC patients in the SEER database were also identified from different subsets. The AAR from 2001 to 2017 were 3.21 (95%CI: 3.12-3.30) per million. Its incidence and mortality rates in PLCNC patients increased at first but seemed to decline in recent years. Besides TNM stage and treatments, older age and male gender were independently associated with poorer survival, while marital status only affected CSS other than OS. The nomograms for OS and CSS presented great predictive ability and calibration performance. Surgery gave significantly more survival benefits to PLCNC patients, and chemotherapy might add survival benefits to stage II-IV. However, radiation therapy seemed to only improve stage III patients’ survival.ConclusionsThis study supported some previous studies in terms of incidence, survival, and treatment options. The mortality rates seemed to decline recently, after an earlier increase. Among PLCNC patients, most of the deaths occurred within the first five years, while other non-PLCNC diseases increased after that. Thus, careful management and follow-up of other comorbidities are of equal importance. Our study may partly solve the dilemma caused by PLCNC’s rarity and inspire more insights in future researches.

scholarly journals Survival After Lobectomy Versus Sublobar Resection for Stage IA Large-Cell Neuroendocrine Carcinoma of the Lung: A Population-Based Study

2021 ◽  
Author(s):  
xiangyang yu ◽  
Zirui Huang ◽  
Mengqi Zhang ◽  
Yongbin Lin ◽  
Rusi Zhang ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Lymph Nodes ◽  
Neuroendocrine Carcinoma ◽  
Early Stage ◽  
Large Cell ◽  
Large Cell Neuroendocrine Carcinoma ◽  
Sublobar Resection ◽  
Oncological Outcomes ◽  
Stage Ia ◽  
Lymph Nodes Dissection

Abstract Background: Due to the low incidence of pulmonary large cell neuroendocrine carcinoma (LCNEC), the survival analysis for comparing lobectomy and sublobar resection (SLR) for stage IA LCNEC remains scarce. Methods: Patients diagnosed with pathological stage IA LCNEC between 1998 and 2016 were extracted from the Survenillance, Epidemiology, and End Results (SEER) database. The oncological outcomes were cancer-specific survival (CSS) and overall survival (OS). Kaplan-Meier analysis and Cox multivariate analysis were used to identify the independent prognostic factors for OS and CSS. Furthermore, propensity score matching (PSM) was performed between SLR and lobectomy to adjust the confounding factors. Results: A total of 308 patients with stage IA LCNEC met the inclusion criteria: 229 patients (74.4%) received lobectomy and 79 patients (25.6%) received SLR. Patients who underwent SLR were older (P<0.001), had smaller tumor size (P=0.010) and fewer lymph nodes dissection (P<0.001). The 5-year CSS and OS rates were 56.5% and 42.9% for SLR, and 67.8% and 55.7% for lobectomy, respectively (P=0.037 and 0.019, respectively). However, multivariate analysis did not identify any differences between SLR group and lobectomy group in CSS (P=0.135) and OS (P=0.285); and the PSM also supported these results. In addition, age at diagnosis and laterality of tumor were identified as significant predictors for CSS and OS, whereas the number of lymph nodes dissection was a significant predictor for CSS. Conclusions: Although SLR is not inferior to lobectomy in terms of oncological outcomes for patients with stage IA LCNEC, more lymph nodes can be dissected or sampled during lobectomy. Lobectomy should be considered as a standard procedure for patients with early-stage LCNEC who are able to withstand lobectomy.

Genetic alterations in early-stage pulmonary large cell neuroendocrine carcinoma

Cancer ◽  
2004 ◽  
Vol 100 (6) ◽  
pp. 1190-1198 ◽  
Author(s):  
Kenzo Hiroshima ◽  
Akira Iyoda ◽  
Kiyoshi Shibuya ◽  
Yukiko Haga ◽  
Tetsuya Toyozaki ◽  
...  
Keyword(s):  
Neuroendocrine Carcinoma ◽  
Early Stage ◽  
Large Cell ◽  
Genetic Alterations ◽  
Large Cell Neuroendocrine Carcinoma

The role of adjuvant therapy in the management of resected large cell neuroendocrine carcinoma (LCNEC) of the lung: A National Cancer Database (NCDB) analysis.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 8529-8529 ◽  
Author(s):  
Lara Ann Kujtan ◽  
Varsha Muthukumar ◽  
Muhammad Toor ◽  
Kevin F Kennedy ◽  
Ashiq Masood ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Neuroendocrine Carcinoma ◽  
Statistical Significance ◽  
Large Cell ◽  
Large Cell Neuroendocrine Carcinoma ◽  
Categorical Variables ◽  
National Cancer Database ◽  
Morbidity Score ◽  
Co Morbidity ◽  
Stage Ia

8529 Background: Large cell neuroendocrine carcinoma (LCNEC) is characterized by aggressive behavior and poor outcomes compared with other non-small cell lung cancers (ONSCLC). Methods: The National Cancer Database (NCDB) was used to identify patients diagnosed with early stage NSCLC (pathologic stage I, II, IIIA) from 2004-2012 who underwent surgical resection. Patients were divided into two groups: LCNEC and ONSCLC. One-way ANOVA was used to compare continuous variables, and chi-squared testing was used to compare categorical variables. Multivariate logistic regression analyses were used to obtain hazard ratios. Results: We identified 1672 patients with resected LCNEC and 134139 with resected ONSCLC. A higher proportion of patients with ONSCLC had a Charlson-Deyo co-morbidity score of 0 compared to LCNEC patients (50.6% vs. 43.8%; p < 0.001). No other significant differences in clinical and demographic characteristics were identified. Overall survival was lower for LCNEC patients across all stages when compared to patients with resected ONSCLC (46 months versus 74 months; 5-year survival 45% versus 57%; p <0.001). Multivariate analysis confirmed the survival benefit for adjuvant chemotherapy in resected LCNEC across all stages, including stage IA, although it did not reach statistical significance (hazard ratio 0.72 (0.51-1.02), p= 0.64; Table). Conclusions: Adjuvant chemotherapy significantly improves survival for stage IB, II and IIIA LCNEC compared to surgery alone. Patients with stage IA LCNEC appear to benefit from adjuvant chemotherapy although it did not reach statistical significance. The overall magnitude of benefit from adjuvant chemotherapy appears to be higher for patients with LCNEC compared to ONSCLC. [Table: see text]

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