Surgical management of large-cell neuroendocrine lung carcinoma: an analysis of 25 cases

Abstract

Background/aim: Large-cell neuroendocrine carcinoma (LCNEC) of the lung is a relatively uncommon and aggressive subset of pulmonary neuroendocrine tumors, which include typical and atypical carcinoid, and small-cell lung cancer. LCNEC of the lung accounts for no more than 1% of all lung cancers. LCNECs show features of high-grade neuroendocrine tumors and patients with LCNEC have a very poor prognosis. Materials and methods: Twenty-five patients (22 males and 3 females; mean years 60.7; range 48 to 77 years) who underwent pulmonary resection for large-cell neuroendocrine carcinoma between January 2004 and December 2014 were investigated retrospectively. Results: Type of surgery, pathologic TNM stage, adjuvant chemotherapy, time of recurrence, site of recurrence, response to treatment, and long-term results were evaluated. The longest patient follow-up period was 83 months. One-, two-, and three-year survival rates of these patients were, respectively, 80.95%, 76.47%, and 50%. Conclusion: Complete surgical resection is the treatment of choice for early-stage LCNEC and chemotherapy after radical surgical treatment improves survival. Follow-up periods after surgery adjuvant chemotherapy will prevent recurrence and patients may survive for many years if complete surgical resection and adjuvant chemotherapy are possible.