Lowczak Anna, Kolasinska-Cwikla Agnieszka, Ćwikła Jarosław B, Osowiecka Karolina, Palucki Jakub, Rzepko Robert, Glinka Lidka, Doboszyńska Anna
Department of Pulmonology, School of Medicine, University of Warmia and Mazury in Olsztyn, Jagiellonska 78, 11-041 Olsztyn, Poland.
Department of Oncology and Radiotherapy "Maria Sklodowska-Curie" Memorial Cancer Center, Roentgena 5, 02-781 Warsaw, Poland.
J Clin Med. 2020 May 7;9(5):1370. doi: 10.3390/jcm9051370.
Large-cell neuroendocrine carcinoma (LCNEC) is a rare malignancy with poor prognosis. The rationale of the study was to determine the survival of LCNEC patients in I-IIIA clinical stages who underwent resection. A total of 53 LCNEC (89%) and combined LCNEC (11%) patients in stages I-IIIA who underwent surgery with radical intent between 2002-2018 were included in the current study. Overall survival (OS) and time to recurrence (TTR) were estimated. Uni- and multivariable analyses were conducted using Cox-regression model. Patients were treated with surgery alone (51%), surgery with radiochemotherapy (4%), with radiotherapy (2%), with adjuvant chemotherapy (41%), or with neoadjuvant chemotherapy (2%). The median (95% Confidence Interval (CI)) OS and TTR was 52 months (20.1-102.1 months) and 20 months (7.0-75.6 months), respectively. Patients treated in clinical stage I showed better OS than patients in stages II-IIIA ( = 0.008). Patients with R0 resection margin (negative margin, no tumor at the margin) and without lymph node metastasis had significantly better TTR. In the multivariate analysis, age was an independent factor influencing OS. Recurrence within 1 year was noted in more than half cases of LCNEC. R0 resection margin and N0 status (no lymph node metastasis) were factors improving TTR. Age >64 years was observed as a main independent factor influencing OS.
大细胞神经内分泌癌（LCNEC）是一种预后较差的罕见恶性肿瘤。本研究的目的是确定接受手术的I-IIIA期临床LCNEC患者的生存率。本研究纳入了2002年至2018年间53例（89%）LCNEC患者和11%的混合性LCNEC患者，这些患者处于I-IIIA期，接受了根治性手术。评估了总生存期（OS）和复发时间（TTR）。使用Cox回归模型进行单变量和多变量分析。患者接受单纯手术治疗（51%）、手术联合放化疗（4%）、放疗（2%）、辅助化疗（41%）或新辅助化疗（2%）。OS和TTR的中位数（95%置信区间（CI））分别为52个月（20.1-102.1个月）和20个月（7.0-75.6个月）。I期临床治疗的患者OS优于II-IIIA期患者（P = 0.008）。切缘R0（阴性切缘，切缘无肿瘤）且无淋巴结转移的患者TTR明显更好。在多变量分析中，年龄是影响OS的独立因素。超过一半的LCNEC病例在1年内出现复发。R0切缘和N0状态（无淋巴结转移）是改善TTR的因素。年龄>64岁是影响OS的主要独立因素。
