Outcomes of Patients with Pulmonary Large Cell Neuroendocrine Carcinoma in I–IV Stage
<i>Background and Objectives</i>: Large cell neuroendocrine cancer is characterised by poor prognosis. The standard of treatment is still not established. The aim of this study was to assess the predictive factors of overall survival (OS) and progression-free survival (PFS) of pulmonary...
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MDPI AG
2021-01-01
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| Online Access: | https://www.mdpi.com/1010-660X/57/2/118 |
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| author | Anna Lowczak Agnieszka Kolasinska-Cwikla Karolina Osowiecka Lidia Glinka Jakub Palucki Robert Rzepko Anna Doboszynska Jaroslaw B. Cwikla |
| author_facet | Anna Lowczak Agnieszka Kolasinska-Cwikla Karolina Osowiecka Lidia Glinka Jakub Palucki Robert Rzepko Anna Doboszynska Jaroslaw B. Cwikla |
| author_sort | Anna Lowczak |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Large cell neuroendocrine cancer is characterised by poor prognosis. The standard of treatment is still not established. The aim of this study was to assess the predictive factors of overall survival (OS) and progression-free survival (PFS) of pulmonary large cell neuroendocrine carcinoma (LCNEC) and combined LCNEC. <i>Materials and Methods</i>: All patients had confirmed pathology stage I-IV disease recorded between period 2002–2018. Survival curves were estimated by Kaplan–Meier method. Uni- and multivariable analysis was conducted using Cox-regression analysis. <i>Results</i>: A total of 132 patients with LCNEC and combined LCNEC were included. Half of them had clinical stage IIIB/C-IV. Patients were treated with radical (<i>n</i> = 67, including surgery alone; resection with neo-adjuvant or adjuvant chemotherapy, radiochemotherapy, or adjuvant radiotherapy; patients treated with radiochemotherapy alone), palliative (<i>n</i> = 41) or symptomatic (<i>n</i> = 24) intention. Seventeen patients were treated with resection margin R1 or R2. Non-small cell carcinoma (NSCLC) chemotherapy (platinum-vinorelbine; PN schedule) and small-cell lung carcinoma (SCLC) chemotherapy approaches (platinum/carboplatinum-etoposide; PE/KE schedule) were administered in 20 and in 55 patients, respectively. The median (95% Confidence Interval (CI)) OS and PFS were 17 months (9.0–36.2 months) and 7 months (3.0–15.0 months), respectively. Patients treated with negative resection margin, with lower clinical stage, without lymph node metastasis, and with size of primary tumour ≤4 cm showed significantly better OS and PFS. The main risk factors with an adverse effect on survival were advanced CS and positive resection margin. <i>Conclusions</i>: Patients with LCNEC characterized poor prognosis. Independent prognostic factors influencing PFS were initial clinical stage and resection margin R0 vs. R1-2. |
| first_indexed | 2024-03-12T11:10:04Z |
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| institution | Directory Open Access Journal |
| issn | 1010-660X |
| language | English |
| last_indexed | 2024-03-12T11:10:04Z |
| publishDate | 2021-01-01 |
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| series | Medicina |
| spelling | doaj.art-fd93ae27ddc34e70af0295cc535220762023-09-02T03:05:26ZengMDPI AGMedicina1010-660X2021-01-015711811810.3390/medicina57020118Outcomes of Patients with Pulmonary Large Cell Neuroendocrine Carcinoma in I–IV StageAnna Lowczak0Agnieszka Kolasinska-Cwikla1Karolina Osowiecka2Lidia Glinka3Jakub Palucki4Robert Rzepko5Anna Doboszynska6Jaroslaw B. Cwikla7Department of Pulmonology, Faculty of Medicine, University of Warmia and Mazury in Olsztyn, Jagiellonska 78, 11-041 Olsztyn, PolandDepartment of Oncology and Radiotherapy, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland Roentgena 5, 02-781 Warsaw, PolandDepartment of Psychology and Sociology of Health and Public Health, School of Public Health, University of Warmia and Mazury in Olsztyn, Warszawska 30, 11-041 Olsztyn, PolandDepartment of Anesthesiology and Intensive Care Faculty of Medicine, University of Warmia and Mazury in Olsztyn, Warszawska 30, 10-082 Olsztyn, PolandDepartment of Radiology, Maria Sklodowska-Curie Institute of Oncology in Warsaw, Roentgena 5, 02-781 Warsaw, PolandSpecialist Hospital in Prabuty, Kuracyjna 30, 82-550 Prabuty, PolandDepartment of Pulmonology, Faculty of Medicine, University of Warmia and Mazury in Olsztyn, Jagiellonska 78, 11-041 Olsztyn, PolandDepartment of Cardiology and Internal Medicine Faculty of Medicine, University of Warmia and Mazury in Olsztyn, Warszawska 30, 10-082 Olsztyn, Poland<i>Background and Objectives</i>: Large cell neuroendocrine cancer is characterised by poor prognosis. The standard of treatment is still not established. The aim of this study was to assess the predictive factors of overall survival (OS) and progression-free survival (PFS) of pulmonary large cell neuroendocrine carcinoma (LCNEC) and combined LCNEC. <i>Materials and Methods</i>: All patients had confirmed pathology stage I-IV disease recorded between period 2002–2018. Survival curves were estimated by Kaplan–Meier method. Uni- and multivariable analysis was conducted using Cox-regression analysis. <i>Results</i>: A total of 132 patients with LCNEC and combined LCNEC were included. Half of them had clinical stage IIIB/C-IV. Patients were treated with radical (<i>n</i> = 67, including surgery alone; resection with neo-adjuvant or adjuvant chemotherapy, radiochemotherapy, or adjuvant radiotherapy; patients treated with radiochemotherapy alone), palliative (<i>n</i> = 41) or symptomatic (<i>n</i> = 24) intention. Seventeen patients were treated with resection margin R1 or R2. Non-small cell carcinoma (NSCLC) chemotherapy (platinum-vinorelbine; PN schedule) and small-cell lung carcinoma (SCLC) chemotherapy approaches (platinum/carboplatinum-etoposide; PE/KE schedule) were administered in 20 and in 55 patients, respectively. The median (95% Confidence Interval (CI)) OS and PFS were 17 months (9.0–36.2 months) and 7 months (3.0–15.0 months), respectively. Patients treated with negative resection margin, with lower clinical stage, without lymph node metastasis, and with size of primary tumour ≤4 cm showed significantly better OS and PFS. The main risk factors with an adverse effect on survival were advanced CS and positive resection margin. <i>Conclusions</i>: Patients with LCNEC characterized poor prognosis. Independent prognostic factors influencing PFS were initial clinical stage and resection margin R0 vs. R1-2.https://www.mdpi.com/1010-660X/57/2/118pulmonary large cell neuroendocrine canceroverall survivalprogression-free survival |
| spellingShingle | Anna Lowczak Agnieszka Kolasinska-Cwikla Karolina Osowiecka Lidia Glinka Jakub Palucki Robert Rzepko Anna Doboszynska Jaroslaw B. Cwikla Outcomes of Patients with Pulmonary Large Cell Neuroendocrine Carcinoma in I–IV Stage Medicina pulmonary large cell neuroendocrine cancer overall survival progression-free survival |
| title | Outcomes of Patients with Pulmonary Large Cell Neuroendocrine Carcinoma in I–IV Stage |
| title_full | Outcomes of Patients with Pulmonary Large Cell Neuroendocrine Carcinoma in I–IV Stage |
| title_fullStr | Outcomes of Patients with Pulmonary Large Cell Neuroendocrine Carcinoma in I–IV Stage |
| title_full_unstemmed | Outcomes of Patients with Pulmonary Large Cell Neuroendocrine Carcinoma in I–IV Stage |
| title_short | Outcomes of Patients with Pulmonary Large Cell Neuroendocrine Carcinoma in I–IV Stage |
| title_sort | outcomes of patients with pulmonary large cell neuroendocrine carcinoma in i iv stage |
| topic | pulmonary large cell neuroendocrine cancer overall survival progression-free survival |
| url | https://www.mdpi.com/1010-660X/57/2/118 |
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