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

Ling Cao; Zhi-Wen Li; Min Wang; Ting-Ting Zhang; Bo Bao; Yun-Peng Liu

doi:10.7717/peerj.6539

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

PeerJ. 2019 Mar 27:7:e6539. doi: 10.7717/peerj.6539. eCollection 2019.

Authors

Ling Cao^#¹, Zhi-Wen Li^#², Min Wang³, Ting-Ting Zhang⁴, Bo Bao¹, Yun-Peng Liu⁵

Affiliations

¹ Department of Radiation Oncology, Cancer Hospital of Jilin Province, Changchun, Jilin, China.
² Department of Anesthesiology, First Hospital of Jilin University, Changchun, Jilin, China.
³ Department of Pathology, Cancer Hospital of Jilin Province, Changchun, Jilin, China.
⁴ Department of Medical Oncology, Cancer Hospital of Jilin Province, Changchun, Jilin, China.
⁵ Department of Thoracic Surgery, First Hospital of Jilin University, Changchun, Jilin, China.

^# Contributed equally.

Abstract

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.

Keywords: Overall survival; Prognosis; Pulmonary large cell neuroendocrine carcinoma; SEER.

Grants and funding

This work is supported by a grant (to Zhi-wen Li) from Fundament Research Funds for Central Universities (451170306057). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.