RT Journal Article
T1 Adjuvant chemotherapy for large-cell neuroendocrine lung carcinoma: results from the European Society for Thoracic Surgeons Lung Neuroendocrine Tumours Retrospective Database
A1 Filosso, Pier Luigi
A1 Guerrera, Francesco
A1 Evangelista, Andrea
A1 Galassi, Claudia
A1 Welter, Stefan
A1 Rendina, Erino Angelo
A1 Travis, William
A1 Lim, Eric
A1 Sarkaria, Inderpal
A1 Thomas, Pascal Alexandre
A1 ESTS Lung Neuroendocrine Working, 
K1 Large-cell neuroendocrine carcinoma
K1 Lung
K1 Neuroendocrine tumours
K1 Surgery
K1 Chemotherapy
K1 Survival
AB OBJECTIVES: Large-cell neuroendocrine carcinoma (LCNC) is a rare tumour characterized by aggressive biological behaviour and poor prognosis. Due to its rarity and the lack of randomized clinical trials, the best treatment is still under debate. Some recent reports indicate that adjuvant chemotherapy (CT) may have a beneficial effect on survival. Our goal was to evaluate this finding using a large series of patients with neuroendocrine tumours obtained from the European Society of Thoracic Surgeons database.METHODS: Data for 400 patients with LCNC operated on in 14 thoracic surgery institutions worldwide between 1992 and 2014 were collected retrospectively. Overall survival was the primary endpoint; we used a multivariable Cox regression model to evaluate which clinical variables may influence patient outcomes; we also focused on the possible prognostic role of adjuvant CT. A propensity score (PS) analysis using the inverse probability of treatment weighting was also carried out.RESULTS: The 3-and 5-year survival rates were 54.1% and 45%, respectively. With the multivariable model, we found that increasing age, Eastern Cooperative Oncology Group Performance Status >= 2 and advanced TNM stage were indicators of poor prognosis. Weak evidence of a higher overall survival in patients receiving adjuvant CT (adjusted hazard ratio 0.73; 95% confidence interval: 0.56-0.96, P = 0.022) was observed.CONCLUSIONS: A trend towards benefit from adjuvant CT has been observed in patients with LCNC. Although surgical procedures remain the mainstay of curative options, combination with other treatments (e.g. neoadjuvant CT/radiotherapy) should be evaluated by future studies.
PB Oxford univ press inc
SN 1010-7940
YR 2017
FD 2017-08-01
LK https://hdl.handle.net/10668/25404
UL https://hdl.handle.net/10668/25404
LA en
DS RISalud
RD Apr 13, 2025