Outcomes of Patients with Pulmonary Large Cell Neuroendocrine Carcinoma in I–IV Stage
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Sources
2.2. Statistical Analysis
3. Results
3.1. Characteristic of Patients
3.2. Comparison of Outcome
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Inclusion Criteria: | |
---|---|
1. | ≥18 years old |
2. | Caucasian race |
3. | LCNEC or combined type LCNEC diagnosis |
4. | The stage of cancer development was determined using UICC TNM classification of Malignant Tumors—8th Edition |
5. | Diagnosis in clinical stage I-IV |
6. | Patients without prior treatment |
7. | Patients with generalized, unresectable of LCNEC before, during and after palliative treatment |
8. | Patients with generalized, unresectable LCNEC treated only symptomatically |
9. | Patients with locally advanced, unresectable LCNEC, combined LCNEC before, during and after radical treatment |
10. | Patients with locally advanced, resectable LCNEC, combined LCNEC before, during and after treatment independently on type of treatment |
All | N = 132 | % | |
---|---|---|---|
Age [years] (range: 36–86, mean 64.1 ± 9.1) | |||
≤64 | 66 | 50 | |
>64 | 66 | 50 | |
Gender | |||
women | 47 | 36 | |
men | 85 | 64 | |
Histopathology | |||
LCNEC | 124 | 94 | |
combined LCNEC | 8 | 6 | |
Clinical stage | |||
I | 22 | 17 | |
II | 19 | 14 | |
IIIA | 22 | 17 | |
IIIB | 13 | 10 | |
IIIC | 3 | 2 | |
IV | 53 | 40 | |
Lymph nodes status | |||
N0 | 38 | 29 | |
N1 | 17 | 13 | |
N2 | 56 | 42 | |
N3 | 21 | 16 | |
Ki67 | |||
≤55 | 31 | 23 | |
>55 | 71 | 54 | |
no data | 30 | 23 | |
Localization | |||
left lung | 60 | 45 | |
right lung | 72 | 55 | |
Intention to treat | |||
radical treatment | 67 | 51 | |
palliative treatment | 41 | 31 | |
symptomatic treatment | 24 | 18 | |
Type of radical treatment | |||
alone surgery | 30 | 45 | |
surgery with neo- or adjuvant chemotherapy or radiochemotherapy or with adjuvant alone radiotherapy | 30 | 45 | |
radiochemotherapy | 7 | 10 | |
Radicality of surgical resection | |||
R0 | 43 | 72 | |
R1-2 | 17 | 28 | |
Type of palliative treatment | |||
resection and palliative chemotherapy | 3 | 7 | |
palliative chemotherapy | 38 | 93 | |
Size of tumour [mm] (range: 7–136, mean 52.2 ± 26.5) | |||
≤4 cm | 50 | 38 | |
>4 cm | 82 | 62 | |
Size of tumour | |||
≤3 cm | 34 | 26 | |
>3–5 cm | 38 | 29 | |
>5–7 cm | 30 | 22.5 | |
>7 cm | 30 | 22.5 | |
Type of chemotherapy | |||
SCLC—chemotherapy | 55 | 71.4 | |
NSCLC—chemotherapy | 20 | 26 | |
other | 2 | 2.6 |
Overall Survval (OS) | Progression-Free Survival (PFS) | ||||||||
---|---|---|---|---|---|---|---|---|---|
Variables | 5-Year (%) | Median OS (95% CI Months) | Log-Rank Test | 5-Year (%) | Median PFS (95% CI Months) | Log-Rank Test | |||
All | 19 | 17 | (9.0–36.2) | p | 13 | 7 | (3.0–15.0) | p | |
Age | |||||||||
≤64 | 25 | 19 | (10.0–52.5) | 0.11 | 18 | 7 | (4.0–25.2) | 0.16 | |
>64 | 12 | 17 | (7.0–28.7) | 5 | 6 | (0.5–12.0) | |||
Gender | |||||||||
women | 24 | 22 | (9.3–51.8) | 0.29 | 13 | 12 | (3.0–28.1) | 0.33 | |
men | 17 | 16 | (7.0–33.1) | 15 | 6 | (3.0–12.0) | |||
Clinical stage | |||||||||
I | 63 | 105 | (25.6–not reached) | <0.001 * | 49 | 54 | (6.0-not reached) | <0.001 ** | |
II | 25 | 28 | (14.5–53.9) | - | 27 | (8.5–40.5) | |||
IIIA | 21 | 31 | (15.6–51.6) | 14 | 12 | (6.0–21.0) | |||
IIIB | 15 | 19 | (11.0–30.2) | - | 6 | (4.0–12.6) | |||
IIIC | - | 13 | (9.0–16.0) | - | 5 | (4.0–6.0) | |||
IV | - | 8 | (3.0–16.0) | - | 3 | (0.0–7.0) | |||
Lymph nodes status | |||||||||
N0 | 54 | 64 | (21.9–not reached) | <0.001 # | 41 | 42 | (7.0-not reached) | <0.001 ## | |
N1 | 9 | 23 | (14.0–36.8) | 12 | 11 | (6.3–24.3) | |||
N2 | 6 | 13 | (6.9–28.4) | - | 4 | (0.0–10.0) | |||
N3 | - | 9 | (3.3–16.0) | - | 3 | (0.0–6.0) | |||
Lymph nodes status | |||||||||
N+ | 6 | 13 | (7.0–25.8) | <0.001 | 3 | 5 | (1.3–10.6) | <0.001 | |
N− | 54 | 64 | (21.9–not reached) | 41 | 42 | (7.0-not reached) | |||
Ki67 | |||||||||
≤55 | 22 | 22 | (11.2–51.6) | 0.56 | 21 | 10 | (3.8–38.5) | 0.66 | |
>55 | 22 | 18 | (7.0–48.5) | 16 | 7 | (3.0–28.2) | |||
Localization | |||||||||
left lung | 18 | 22 | (13.0–43.7) | 0.13 | 12 | 9 | (5.0–17.0) | 0.26 | |
right lung | 20 | 15 | (7.0–36.3) | 15 | 4 | (2.0–13.0) | |||
Intention to treat | |||||||||
radical treatment | 39 | 48 | (19.0–87.5) | <0.001 ^ | 26 | 16 | (6.0–59.0) | <0.001 ^^ | |
palliative treatment | - | 12 | (9.0–17.0) | - | 4 | (3.0–9.1) | |||
symptomatic treatment | - | 3 | (1.0–7.0) | - | 0 | (0.0–3.0) | |||
Type of radical treatment | |||||||||
Surgery alone | 23 | 37 | (14.2–54.0) | 0.35 | 22 | 11 | (4.5–47.9) | ||
Surgery with neo-or adjuvant chemotherapy or radiochemotherapy or with alone adjuvant radiotherapy | 45 | 48 | (17.2–59.2) | 29 | 17 | (8.6-not reached) | 0.28 | ||
Radiochemotherapy | |||||||||
Surgery alone | 23 | 37 | (14.2–54.0) | 0.26 | 22 | 11 | (4.5–47.9) | ||
Surgery with neo-or adjuvant chemotherapy or radiochemotherapy or with adjuvant radiotherapy alone | 46 | 58 | (22.1–not reached) | 36 | 31 | (9.0-not reached) | 0.16 | ||
Surgery alone | 23 | 37 | (14.2–54.0) | 0.87 | 22 | 11 | (4.5–47.9) | 0.69 | |
Radiochemotherapy | 36 | 35 | (16.8–44.9) | - | 10 | (5.5–21.8) | |||
Radicality of surgical resection | |||||||||
R0 | 47 | 58 | (22.0–not reached) | 0.09 | 40 | 31 | (7.0-not reached) | 0.02 | |
R1-2 | 15 | 27 | (11.8–39.3) | 7 | 9 | (3.0–18.7) | |||
Type of palliative treatment | |||||||||
Resection and palliative chemotherapy | - | 6 | (6.0–22.0) | 0.94 | - | 13 | (2.0–13.0) | 0.50 | |
Palliative chemotherapy | - | 12 | (9.0–17.0) | - | 4 | (3.0–9.0) | |||
Size of tumour | |||||||||
≤4 cm | 30 | 29 | (14.9–81.7) | <0.001 | 22 | 10 | (5.0–46.1) | 0.002 | |
>4 cm | 12 | 13 | (6.4–28.0) | 8 | 5 | (1.3–12.0) | |||
Size of tumour | |||||||||
≤3 cm | 36 | 48 | (16.1–not reached) | <0.001 § | 24 | 11 | (6.0–52.0) | <0.001 §§ | |
>3–5 cm | 16 | 19 | (7.3–36.8) | 13 | 9 | (3.0–18.4) | |||
>5–7 cm | 19 | 16 | (6.4–31.2) | 13 | 7 | (1.0–15.6) | |||
>7 cm | 6 | 12 | (3.5–17.0) | - | 4 | (0.0–8.4) | |||
Type of chemotherapy | |||||||||
SCLC—chemotherapy | 22 | 21 | (11.4–40.6) | 0.93 | 13 | 9 | (4.0–16.3) | 0.86 | |
NSCLC—chemotherapy | 27 | 17 | (12.0–not reached) | 16 | 9 | (4.0–10.7) |
Overall Survval (OS) | Progression-Free Survival (PFS) | ||||||
---|---|---|---|---|---|---|---|
Variables | HR (95% CI) | p | HR (95% CI) | p | |||
Age | ≤64 | 1.00 | Reference | 1.00 | Reference | ||
>64 | 1.40 | (0.93–2.10) | 0.11 | 1.31 | (0.89–1.92) | 0.17 | |
Gender | women | 1.00 | Reference | 1.00 | Reference | ||
men | >1.24 | >(0.82–1.89) | 0.31 | >1.20 | >(0.81–1.80) | 0.36 | |
Clinical stage | I | 1.00 | Reference | 1.00 | Reference | ||
II | 3.20 | (1.19–8.66) | 0.02 | 1.58 | (0.68–3.69) | 0.29 | |
IIIA | 3.12 | (1.20–8.12) | 0.02 | 2.33 | (1.08–5.04) | 0.03 | |
IIIB | 5.44 | (1.96–15.13) | 0.001 | 3.53 | (1.46–8.56) | 0.005 | |
IIIC | 14.40 | (3.44–60.27) | <0.001 | 7.95 | (2.10–30.12) | 0.002 | |
IV | 15.90 | (6.48–39.02) | <0.001 | 8.59 | (4.15–17.82) | <0.001 | |
Lymph nodes status | N0 | 1.00 | Reference | 1.00 | Reference | ||
N1 | 2.52 | (1.19–5.31) | 0.02 | 0.86 | (0.38–1.93) | 0.22 | |
N2 | 4.33 | (2.40–7.82) | <0.001 | 3.85 | (2.27–6.54) | 0.007 | |
N3 | 9.42 | (4.61–19.28) | <0.001 | 5.96 | (3.11–11.40) | <0.001 | |
Ki67 | ≤55 | 1.00 | Reference | 1.00 | Reference | ||
>55 | 1.16 | (0.69–1.93) | 0.57 | 1.11 | (0.68–1.79) | 0.68 | |
Localization | left lung | 1.00 | Reference | 1.00 | Reference | ||
right lung | 1.35 | (0.90–2.02) | 0.14 | 1.23 | (0.84–1.80) | 0.29 | |
Intention to treat | radical treatment | 1.00 | Reference | 1.00 | Reference | ||
palliative treatment | 4.88 | (2.93–8.15) | <0.001 | 3.58 | (2.21–5.80) | 0.13 | |
symptomatic treatment | 11.10 | (6.15–20.03) | <0.001 | 6.73 | (3.83–11.82) | <0.001 | |
Radicality of surgical resection | R0 | 1.00 | Reference | 1.00 | Reference | ||
R1-2 | 2.28 | (1.12–4.63) | 0.02 | 2.43 | (1.30–4.54) | 0.005 | |
Size of tumour | ≤3 cm | 1.00 | Reference | 1.00 | Reference | ||
>3–5 cm | 1.27 | (0.66–2.45) | 0.75 | 0.90 | (0.49–1.65) | 0.77 | |
>5–7 cm | 2.63 | (1.39–4.96) | 0.45 | 1.65 | (0.93–2.93) | 0.94 | |
>7 cm | 4.35 | (2.29–8.24) | <0.001 | 2.98 | (1.69–5.26) | <0.001 |
Overall Survival (OS) | Progression-Free Survival (PFS) | ||||||
---|---|---|---|---|---|---|---|
Variables | HR (95% CI) | p | HR (95% CI) | p | |||
Clinical stage | I | 1.00 | Reference | 1.00 | Reference | ||
II | 4.00 | (1.43–11.16) | 0.008 | 2.08 | (0.86–5.01) | 0.10 | |
IIIA | 1.81 | (0.55–5.98) | 0.33 | 1.12 | (0.43–2.92) | 0.81 | |
IIIB | 3.50 | (0.69–17.70) | 0.13 | 1.19 | (0.24–5.96) | 0.83 | |
IIIC | - | - | - | - | - | - | |
IV | 1.90 | (0.23–15.51) | 0.55 | 10.53 | (2.29–48.38) | 0.002 | |
Intention to treat | radical treatment | 1.00 | Reference | 1.00 | Reference | ||
palliative treatment | 2.27 | (0.23–22.02) | 0.48 | 0.34 | (0.05–2.11) | 0.24 | |
symptomatic treatment | 1.27 | (0.14–11.62) | 0. 83 | 0.44 | (0.05–4.01) | 0.47 | |
Radicality of surgical resection | R0 | 1.00 | Reference | 1.00 | Reference | ||
R1-2 | 2.38 | (0.79–7.17) | 0.12 | 3.06 | (1.26–7.42) | 0.01 |
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Lowczak, A.; Kolasinska-Cwikla, A.; Osowiecka, K.; Glinka, L.; Palucki, J.; Rzepko, R.; Doboszynska, A.; Cwikla, J.B. Outcomes of Patients with Pulmonary Large Cell Neuroendocrine Carcinoma in I–IV Stage. Medicina 2021, 57, 118. https://doi.org/10.3390/medicina57020118
Lowczak A, Kolasinska-Cwikla A, Osowiecka K, Glinka L, Palucki J, Rzepko R, Doboszynska A, Cwikla JB. Outcomes of Patients with Pulmonary Large Cell Neuroendocrine Carcinoma in I–IV Stage. Medicina. 2021; 57(2):118. https://doi.org/10.3390/medicina57020118
Chicago/Turabian StyleLowczak, Anna, Agnieszka Kolasinska-Cwikla, Karolina Osowiecka, Lidia Glinka, Jakub Palucki, Robert Rzepko, Anna Doboszynska, and Jaroslaw B. Cwikla. 2021. "Outcomes of Patients with Pulmonary Large Cell Neuroendocrine Carcinoma in I–IV Stage" Medicina 57, no. 2: 118. https://doi.org/10.3390/medicina57020118