Role of surgery in high-grade neuroendocrine tumors of the lung

Turk Gogus Kalp Damar Cerrahisi Derg. 2022 Jul 29;30(3):389-394. doi: 10.5606/tgkdc.dergisi.2022.19700. eCollection 2022 Jul.

Abstract

Background: This study aims to evaluate the surgical results for high-grade neuroendocrine carcinomas and to identify factors that influence prognosis.

Methods: Between January 2009 and December 2017, a total of 71 patients (58 males, 13 females; mean age: 62±9.6 years; range, 38 to 78 years) with a high-grade neuroendocrine carcinoma of the lung were retrospectively analyzed. Overall survival and five-year overall survival rates were evaluated.

Results: The mean overall survival was 60.7±6.9 months with a five-year survival rate of 44.3%. The mean overall survival and five-year overall survival rates according to disease stage were as follows: Stage 1, 67±10.8 months (46%); Stage 2, 61.4±10.8 months (45%); and Stage 3, 33.2±8.6 months (32%) (p=0.02). The mean overall survival and five-year overall survival rate according to histological types were as follows: in large cell neuroendocrine carcinoma, 59.4±9.2 months (45%); in small cell neuroendocrine carcinoma, 68.6±12.2 months (43%); and in combined-type neuroendocrine carcinoma, 40.9±10.1 months (35%) (p=0.34).

Conclusion: Thoracic surgeons should be very selective in performing pulmonary resection in patients with Stage 3 high-grade neuroendocrine carcinomas and combined cell subtype tumors.

Keywords: Large cell lung carcinoma; neuroendocrine tumor; small cell lung carcinoma; thoracic neoplasm.