Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651, Dongfeng East Road, Yuexiu District, Guangzhou, 510060, China.
Senior Ward/ Phase I Clinical Trial Ward, Sichuan Cancer Hospital & Institue, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, China.
BMC Pulm Med. 2022 Sep 22;22(1):360. doi: 10.1186/s12890-022-02097-6.
Lymphoepithelioma-like carcinoma (LELC) is a rare and unique subtype of cancer that histologically resembles undifferentiated nasopharyngeal carcinoma (NPC). The population-based analysis of LELC and the optimal treatment remains unclear.
This real-world, retrospective study investigated 770 patients with LELC for primary site, treatment, and survival outcomes from 2005 to 2019 from five cancer centres in China. The overall survival (OS) of different subgroups was appraised by log-rank tests and Kaplan-Meier analysis.
Primary sites LELC included the lung (597 cases, 77.5%), salivary gland (115 cases, 14.9%), and others. The median progression-free survival (PFS) of LELC patients was 47.4 months. The median overall survival (OS) was not reached. The 5-year survival rate for LELC patients was 77.8%. Most patients in stages I and II received surgery. The majority of patients in stage III received surgery and radiotherapy. More than half of the patients in stage IV received chemotherapy. Among relapsed or metastatic cases receiving chemotherapy, patients who received immunotherapy at any time presented with a superior OS than those without immunotherapy (P < 0.0001, HR = 0.39, 95% CI 0.25-0.63). Compared with the SEER database, patients with LELC had a better prognosis than NPC, with a 5-year overall survival of 77.3% vs. 56.8% (P < 0.001).
Our data provide treatment patterns and outcomes for LELC from various primary sites. Randomized controlled studies are necessary to further define the standard of care for patients with LELC. Trial registration This clinical trial was registered at ClinicalTrials.gov (No. NCT04614818).
淋巴上皮样癌（LELC）是一种罕见且独特的癌症亚型，在组织学上类似于未分化鼻咽癌（NPC）。LELC 的基于人群的分析和最佳治疗方法仍不清楚。
本回顾性真实世界研究调查了来自中国 5 家癌症中心的 770 例 LELC 患者的原发部位、治疗和生存结局，时间范围为 2005 年至 2019 年。采用对数秩检验和 Kaplan-Meier 分析评估不同亚组的总生存率（OS）。
LELC 的原发部位包括肺（597 例，77.5%）、唾液腺（115 例，14.9%）和其他部位。LELC 患者的中位无进展生存期（PFS）为 47.4 个月。中位总生存期（OS）未达到。LELC 患者的 5 年生存率为 77.8%。大多数 I 期和 II 期患者接受了手术。大多数 III 期患者接受了手术和放疗。超过一半的 IV 期患者接受了化疗。在接受化疗的复发或转移性病例中，任何时候接受免疫治疗的患者的 OS 均优于未接受免疫治疗的患者（P<0.0001，HR=0.39，95%CI 0.25-0.63）。与 SEER 数据库相比，LELC 患者的预后优于 NPC，5 年总生存率为 77.3%对 56.8%（P<0.001）。
我们的数据为来自不同原发部位的 LELC 提供了治疗模式和结局。需要进行随机对照研究来进一步确定 LELC 患者的标准治疗方法。
本临床试验在 ClinicalTrials.gov 注册（编号：NCT04614818）。
