Large Cell Neuroendocrine Tumor Size >3 cm Negatively Impacts Long-Term Outcomes After R0 Resection
| Autor: | Michal Hubka, Francesco Guerrera, Ralph W. Aye, Nicola Rotolo, Pier Luigi Filosso, Amir A Sarkeshik, Andrea Imperatori, Brian E. Louie, Eric Vallières, Farhood Farjah, Stephen J. Kaplan, Kimberly E Costas, Alessandra Siciliani, Maria Cattoni, Lisa M. Brown, Alexander S. Farivar, Catherine Mann, Stefano Margaritora, Grace Wandell |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Oncology
Male medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Malignancy 03 medical and health sciences 0302 clinical medicine Internal medicine Carcinoma Medicine Humans Survival rate Aged Retrospective Studies business.industry Large cell Retrospective cohort study Large Cell Middle Aged medicine.disease Carcinoma Large Cell Carcinoma Neuroendocrine Female Lymph Node Excision Neoplasm Recurrence Local Survival Rate Tumor Burden Radiation therapy Neuroendocrine Neoplasm Recurrence Local 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Surgery Lymphadenectomy business Abdominal surgery |
| Popis: | Minimal knowledge exists regarding the outcome, prognosis and optimal treatment strategy for patients with pulmonary large cell neuroendocrine carcinomas (LCNEC) due to their rarity. We aimed to identify factors affecting survival and recurrence after resection to inform current treatment strategies.We retrospectively reviewed 72 patients who had undergone a curative resection for LCNEC in 8 centers between 2000 and 2015. Univariable and multivariable analyses were performed to identify the factors influencing recurrence, disease-specific survival and overall survival. These included age, gender, previous malignancy, ECOG performance status, symptoms at diagnosis, extent of resection, extent of lymphadenectomy, additional chemo- and/or radiotherapy, tumor location, tumor size, pT, pleural invasion, pN and pStage.Median follow-up was 47 (95%CI 41-79) months; 5-year disease-specific and overall survival rates were 57.6% (95%CI 41.3-70.9) and 47.4% (95%CI 32.3-61.1). There were 22 systemic recurrences and 12 loco-regional recurrences. Tumor size was an independent prognostic factor for systemic recurrence [HR: 1.20 (95%CI 1.01-1.41); p = 0.03] with a threshold value of 3 cm (AUC = 0.71). For tumors ≤3 cm and3 cm, 5-year freedom from systemic recurrence was 79.2% (95%CI 43.6-93.6) and 38.2% (95%CI 20.6-55.6) (p 0.001) and 5-year disease-specific survival was 60.7% (95%CI 35.1-78.8) and 54.2% (95%CI 32.6-71.6) (p = 0.31), respectively.A large proportion of patients with surgically resected LCNEC will develop systemic recurrence after resection. Patients with tumors3 cm have a significantly higher rate of systemic recurrence suggesting that adjuvant chemotherapy should be considered after complete resection of LCNEC3 cm, even in the absence of nodal involvement. |
| Databáze: | OpenAIRE |
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