Disparity in clinical outcomes between pure and combined pulmonary large-cell neuroendocrine carcinoma: A multi-center retrospective study
| Autor: | Ye Li, Lin Wu, Qian Chu, Zheng-Bo Han, Gen Lin, Wen-Zhao Zhong, Yi-Long Wu, Fan Yang, Bo Zhu, Hong-Mei Zhang, Jinliang Wang, Jie Hu, Meng-Xia Li, Jia-Tao Zhang, Li-Xu Yan, Huijuan Wang, Zhengfei Zhu, Xiao-Rong Dong, C. Xu, Zhengbo Song, Jie Lin, Zong-Yang Yu |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Pulmonary and Respiratory Medicine Oncology Adult Male Cancer Research medicine.medical_specialty Lung Neoplasms medicine.medical_treatment 03 medical and health sciences Young Adult 0302 clinical medicine Internal medicine Carcinoma Non-Small-Cell Lung Antineoplastic Combined Chemotherapy Protocols medicine Humans Aged Retrospective Studies Aged 80 and over Chemotherapy business.industry Proportional hazards model Retrospective cohort study Health Status Disparities Large cell neuroendocrine carcinoma of the lung Middle Aged medicine.disease Prognosis Small Cell Lung Carcinoma Carcinoma Neuroendocrine Survival Rate Regimen 030104 developmental biology 030220 oncology & carcinogenesis Cohort Adenocarcinoma Carcinoma Large Cell Female business Adjuvant Follow-Up Studies |
| Zdroj: | Lung cancer (Amsterdam, Netherlands). 139 |
| ISSN: | 1872-8332 |
| Popis: | Objectives The 2015 World Health Organization classification defines pulmonary large-cell neuroendocrine carcinoma (LCNEC) as a high-grade neuroendocrine carcinoma. However, the clinical characteristics and prognostic factors of pure LCNEC and combined LCNEC remain unclear. Hence, we performed a multi-center retrospective study to compare the clinical outcomes of pure versus combined LCNEC. Materials and methods Data from 381 patients with pulmonary LCNEC admitted to 17 Chinese institutes between 2009 and 2016 were collected retrospectively. Clinical characteristics and prognosis were analyzed among patients receiving adjuvant (adjuvant group; n = 56) and first-line (first-line group; n = 146) chemotherapy, as well as among patients receiving small cell lung cancer (SCLC) and non-SCLC (NSCLC) chemotherapy regimens. The Kaplan-Meier method and multivariable Cox regression were used to identify clinicopathological variables that might influence patient outcomes. Results Expression levels of neuroendocrine markers (synaptophysin, chromogranin-A, CD56) were associated with patients' prognosis in the total study cohort. In the adjuvant group, median disease-free survival was non-significantly longer for SCLC-based regimens than for NSCLC-based regimens (P = 0.112). In the first-line group, median progression-free survival was significantly longer for SCLC-based regimens than for NSCLC-based regimens (11.5 vs. 7.2 months, P = 0.003). Among patients with combined LCNEC, adenocarcinoma was the most common combined component, accounting for 70.0 % of cases. Additionally, median overall survival was non-significantly shorter for combined LCNEC than for pure LCNEC (P = 0.083). Conclusion The SCLC regimen is a more effective choice, as either first-line or adjuvant chemotherapy, when compared to the NSCLC regimen for LCNEC treatment. Further studies are needed to clarify the survival differences between patients with pure-, and combined LCNEC. |
| Databáze: | OpenAIRE |
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