scholarly journals Clinicopathological characteristics and prognosis of pulmonary large cell neuroendocrine carcinoma aged ≥65 years

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e6824
Author(s):  
Ling Cao ◽  
Ling Zhao ◽  
Min Wang ◽  
Xu he Zhang ◽  
Zhu-chun Yang ◽  
...  
Keyword(s):  
Neuroendocrine Carcinoma ◽  
Tumor Size ◽  
Large Cell ◽  
The Elderly ◽  
Clinicopathological Characteristics ◽  
Large Cell Neuroendocrine Carcinoma ◽  
Cancer Specific Survival ◽  
White Ethnicity ◽  
Lower Stage ◽  
Primary Endpoints

Objective The present study was designed to better characterize the clinicopathological features and prognosis in patients aged ≥65 years with pulmonary large cell neuroendocrine carcinoma (LCNEC). Methods Eligible patients with pulmonary LCNEC were retrieved from the Surveillance, Epidemiology, and End Results database between January 2004 and December 2013. The primary endpoints included cancer-specific survival (CSS) and overall survival (OS). Results Data of 1,619 eligible patients with pulmonary LCNEC were collected. These patients were subsequently categorized into two groups: 890 patients in the older group (age ≥65 years), and 729 in the younger group (age <65 years). More patients were of white ethnicity, stage I, married, and with tumor size <5 cm in the older group in comparison to the younger group. However, there were a significantly lower proportion of patients undergoing surgery, chemotherapy, and radiotherapy in the older group. The 5-year CSS rates of the younger group and older group were 23.94% and 17.94% (P = 0.00031), respectively, and the 5-year OS rates were 20.51% and 13.47% (P < 0.0001), respectively. Multivariate analyses indicated that older age (CSS: HR 1.20, 95% CI [1.07–1.36], P = 0.0024; OS: HR 1.26, 95% CI [1.12–1.41], P < 0.0001) was an independent risk factor for poor prognosis. The mortality risk of the elderly increased in almost every subgroup, especially in OS. Finally, significant predictors for better OS and CSS in patients over age 65 included tumor size <5 cm, lower stage, and receiving surgery, chemotherapy, or radiotherapy. Conclusion The prognosis of patients aged ≥65 years with pulmonary LCNEC was worse than that of younger patients. However, active and effective therapy could significantly improve the survival of older patients with pulmonary LCNEC.

scholarly journals The role of radiotherapy in pulmonary large cell neuroendocrine carcinoma: propensity score matching analysis

2020 ◽  
Vol 61 (4) ◽  
pp. 594-601
Author(s):  
Ling Cao ◽  
Hong-Fen Wu ◽  
Ling Zhao ◽  
Yan Bai ◽  
Zhi-lan Jiang ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Neuroendocrine Carcinoma ◽  
Tumor Size ◽  
Large Cell ◽  
Large Cell Neuroendocrine Carcinoma ◽  
Stage Ii ◽  
Cancer Specific Survival ◽  
Propensity Score Matching Analysis ◽  
Comparison Groups

Abstract The aim of the study was to investigate the survival advantage of radiotherapy (RT) in patients with pulmonary large cell neuroendocrine carcinoma (LCNEC). Patients with pulmonary LCNEC were extracted from the Surveillance, Epidemiology, and End Results (SEER) dataset between January 2004 and December 2013. Propensity score matching (PSM) analysis with 1:1 was used to ensure well-balanced characteristics of all comparison groups. A total of 1480 eligible cases were identified, with a median follow-up time of 11 months (0–131 months). After PSM, 980 patients were classified in no radiotherapy (No RT) and radiotherapy (RT) groups (n = 490 each). Patients in the RT group harbored significantly higher 3- and 5-year overall survival (OS) and cancer-specific survival (CSS) rates compared to those in the No RT group (both P &lt; 0.05). Furthermore, RT was an independent favorable prognostic factor of OS as well as CSS in multivariate analysis, both before [OS: hazard ratio (HR) 0.840, 95% confidence interval (CI) 0.739–0.954, P = 0.007; CSS: HR 0.847, 95% CI 0.741–0.967, P = 0.014] and after (OS: HR 0.854, 95% CI 0.736–0.970, P = 0.016; CSS: HR 0.848, 95% CI 0.735–0.978, P = 0.023) PSM. In subgroup analysis, American Joint Committee on Cancer (AJCC) stage II and III, tumor size 5-10 cm, patients who underwent no surgery, or patients who received chemotherapy could significantly benefit from RT (all P &lt; 0.05). To sum up, our findings suggested that RT could prolong the survival of patients with pulmonary LCNEC, especially those with stage II and III, tumor size 5-10 cm, those with no surgery, or those who received chemotherapy.

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

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e6539 ◽  
Author(s):  
Ling Cao ◽  
Zhi-wen Li ◽  
Min Wang ◽  
Ting-ting Zhang ◽  
Bo Bao ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Neuroendocrine Carcinoma ◽  
Proportional Hazards Model ◽  
Wedge Resection ◽  
Large Cell ◽  
Clinicopathological Characteristics ◽  
Large Cell Neuroendocrine Carcinoma ◽  
Cox Proportional Hazards Model ◽  
Rank Test ◽  
Ajcc Stage

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.

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