Survival and prognosis of lung large cell neuroendocrine carcinoma

Bull Cancer. 2021 Oct;108(10):981-987. doi: 10.1016/j.bulcan.2021.04.010. Epub 2021 Aug 12.


Introduction: Only a few large-scale studies have focused on large cell neuroendocrine carcinoma, a rare type of pulmonary malignancy, and uniform diagnostic criteria and standardized treatments are lacking. This study aimed to assess the treatment outcomes and factors influencing patients' prognosis with large cell neuroendocrine carcinoma.

Methods: The data of 55 patients with pathologically confirmed large cell neuroendocrine carcinoma, treated at our hospital from January 2013 to January 2018, were collected. Relationships between clinical characteristics, diagnoses, treatment outcomes, and prognoses were retrospectively analyzed.

Results: Patients were followed for a median of 18.5 (0.5-41.0) months. Thirty-four patients died before the final follow-up, resulting in a median overall survival of 17.9 (0.5-36.0) months, with 1-, 2-, and 3-year survival rates of 69.1%, 23.6%, and 1.8%, respectively. Single-factor analysis identified gender (P=0.036), smoking history (P=0.008), obstructive atelectasis (P=0.032), regional lymph node metastasis (P=0.020), and treatment selection (P=0.000) as factors influencing overall survival. Multifactor analysis identified treatment selection as an independent survival prognostic factor. Particularly, significant differences were observed between the combination therapies (surgery+chemotherapy, surgery+radiotherapy, surgery+radiotherapy+chemotherapy, and concurrent chemoradiotherapy) and single-therapy approaches (chemotherapy or radiotherapy alone; P<0.001), but not among the combination therapies (P=0.216).

Discussion: Male patients with large cell neuroendocrine carcinoma with a history of smoking, obstructive atelectasis, and regional lymph node metastasis have a particularly poor prognosis. Our observation of the treatment approach as an independent survival prognostic factor suggests that combination therapies may yield survival benefits to patients.

Keywords: Combination therapy; Malignité pulmonaire; Pulmonary malignancy; Radiotherapy; Radiothérapie; Thérapie combinée.

MeSH terms

  • Carcinoma, Large Cell / mortality*
  • Carcinoma, Large Cell / therapy
  • Carcinoma, Neuroendocrine / mortality*
  • Carcinoma, Neuroendocrine / therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Lung Neoplasms / mortality*
  • Lung Neoplasms / therapy
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Prognosis
  • Pulmonary Atelectasis / complications
  • Rare Diseases / mortality*
  • Rare Diseases / therapy
  • Retrospective Studies
  • Sex Factors
  • Smoking / adverse effects
  • Survival Rate
  • Treatment Outcome