Yuke Mao, Hao Chang, Lu Wang, Jinlong Teng, Tianjun Li, Luca Ampollini, Yoshinobu Ichiki, Robert A Ramirez, Hong Liu, Baohui Han, Jing Wang, Yanan Wang
{"title":"肺大细胞神经内分泌癌与小细胞肺癌手术切除的临床病理特征及预后比较。","authors":"Yuke Mao, Hao Chang, Lu Wang, Jinlong Teng, Tianjun Li, Luca Ampollini, Yoshinobu Ichiki, Robert A Ramirez, Hong Liu, Baohui Han, Jing Wang, Yanan Wang","doi":"10.21037/jtd-2025-345","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Pulmonary large-cell neuroendocrine carcinoma (LCNEC) and small-cell lung cancer (SCLC) are classified as types of high-grade neuroendocrine carcinoma (HGNEC). The aim of this study was to determine the similarities and differences in clinical features and prognosis between LCNEC and SCLC.</p><p><strong>Methods: </strong>We retrospectively compared the clinical features and prognosis of LCNEC and SCLC, along with well as their two subtypes, including pure LCNEC (P-LCNEC) and combined LCNEC (C-LCNEC) and SCLC combined with LCNEC and SCLC combined with non-LCNEC, respectively. Disease-free survival (DFS) and overall survival (OS) were calculated using the Kaplan-Meier method.</p><p><strong>Results: </strong>We included 341 patients with LCNEC and 580 patients with SCLC who underwent surgical treatment. Significant differences in smoking history, primary site, tumor location, pathological (p) N stage, pTNM stage, and visceral pleural invasion (VPI) were observed between LCNEC and SCLC groups (all P values <0.05). The subgroups of LCNEC (P-LCNEC and C-LCNEC) and SCLC (SCLC/LCNEC and SCLC/non-LCNEC) displayed differences in smoking history, primary site, tumor location, pT stage, pN stage, pTNM stage, VPI, adjuvant chemotherapy, and postoperative adjuvant radiotherapy. LCNEC and its subtypes P-LCNEC and C-LCNEC were associated with superior DFS and OS than were SCLC and its subtypes SCLC/LCNEC and SCLC/non-LCNEC (DFS: P=0.008, P=0.001, P=0.049; OS: P=0.005, P=0.005, P=0.006). Compared to patients who did not receive adjuvant chemotherapy, those with stage I SCLC or LCNEC who underwent adjuvant chemotherapy demonstrated a significantly improved DFS (P=0.005 and P=0.048) and OS (P=0.004 and P=0.03).</p><p><strong>Conclusions: </strong>LCNEC and SCLC, as well as their subtypes, have distinct clinical features and survival outcomes. SCLC exhibited more malignant biological behavior and was associated with a worse prognosis compared to LCNEC. Postoperative chemotherapy is recommended for patients with stage I HGNEC.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2394-2410"},"PeriodicalIF":2.1000,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090107/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparison of clinicopathologic features and prognosis between surgically resected pulmonary large-cell neuroendocrine carcinoma and small-cell lung cancer.\",\"authors\":\"Yuke Mao, Hao Chang, Lu Wang, Jinlong Teng, Tianjun Li, Luca Ampollini, Yoshinobu Ichiki, Robert A Ramirez, Hong Liu, Baohui Han, Jing Wang, Yanan Wang\",\"doi\":\"10.21037/jtd-2025-345\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Pulmonary large-cell neuroendocrine carcinoma (LCNEC) and small-cell lung cancer (SCLC) are classified as types of high-grade neuroendocrine carcinoma (HGNEC). The aim of this study was to determine the similarities and differences in clinical features and prognosis between LCNEC and SCLC.</p><p><strong>Methods: </strong>We retrospectively compared the clinical features and prognosis of LCNEC and SCLC, along with well as their two subtypes, including pure LCNEC (P-LCNEC) and combined LCNEC (C-LCNEC) and SCLC combined with LCNEC and SCLC combined with non-LCNEC, respectively. Disease-free survival (DFS) and overall survival (OS) were calculated using the Kaplan-Meier method.</p><p><strong>Results: </strong>We included 341 patients with LCNEC and 580 patients with SCLC who underwent surgical treatment. Significant differences in smoking history, primary site, tumor location, pathological (p) N stage, pTNM stage, and visceral pleural invasion (VPI) were observed between LCNEC and SCLC groups (all P values <0.05). The subgroups of LCNEC (P-LCNEC and C-LCNEC) and SCLC (SCLC/LCNEC and SCLC/non-LCNEC) displayed differences in smoking history, primary site, tumor location, pT stage, pN stage, pTNM stage, VPI, adjuvant chemotherapy, and postoperative adjuvant radiotherapy. LCNEC and its subtypes P-LCNEC and C-LCNEC were associated with superior DFS and OS than were SCLC and its subtypes SCLC/LCNEC and SCLC/non-LCNEC (DFS: P=0.008, P=0.001, P=0.049; OS: P=0.005, P=0.005, P=0.006). Compared to patients who did not receive adjuvant chemotherapy, those with stage I SCLC or LCNEC who underwent adjuvant chemotherapy demonstrated a significantly improved DFS (P=0.005 and P=0.048) and OS (P=0.004 and P=0.03).</p><p><strong>Conclusions: </strong>LCNEC and SCLC, as well as their subtypes, have distinct clinical features and survival outcomes. SCLC exhibited more malignant biological behavior and was associated with a worse prognosis compared to LCNEC. Postoperative chemotherapy is recommended for patients with stage I HGNEC.</p>\",\"PeriodicalId\":17542,\"journal\":{\"name\":\"Journal of thoracic disease\",\"volume\":\"17 4\",\"pages\":\"2394-2410\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-04-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090107/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of thoracic disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21037/jtd-2025-345\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/27 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of thoracic disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/jtd-2025-345","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/27 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Comparison of clinicopathologic features and prognosis between surgically resected pulmonary large-cell neuroendocrine carcinoma and small-cell lung cancer.
Background: Pulmonary large-cell neuroendocrine carcinoma (LCNEC) and small-cell lung cancer (SCLC) are classified as types of high-grade neuroendocrine carcinoma (HGNEC). The aim of this study was to determine the similarities and differences in clinical features and prognosis between LCNEC and SCLC.
Methods: We retrospectively compared the clinical features and prognosis of LCNEC and SCLC, along with well as their two subtypes, including pure LCNEC (P-LCNEC) and combined LCNEC (C-LCNEC) and SCLC combined with LCNEC and SCLC combined with non-LCNEC, respectively. Disease-free survival (DFS) and overall survival (OS) were calculated using the Kaplan-Meier method.
Results: We included 341 patients with LCNEC and 580 patients with SCLC who underwent surgical treatment. Significant differences in smoking history, primary site, tumor location, pathological (p) N stage, pTNM stage, and visceral pleural invasion (VPI) were observed between LCNEC and SCLC groups (all P values <0.05). The subgroups of LCNEC (P-LCNEC and C-LCNEC) and SCLC (SCLC/LCNEC and SCLC/non-LCNEC) displayed differences in smoking history, primary site, tumor location, pT stage, pN stage, pTNM stage, VPI, adjuvant chemotherapy, and postoperative adjuvant radiotherapy. LCNEC and its subtypes P-LCNEC and C-LCNEC were associated with superior DFS and OS than were SCLC and its subtypes SCLC/LCNEC and SCLC/non-LCNEC (DFS: P=0.008, P=0.001, P=0.049; OS: P=0.005, P=0.005, P=0.006). Compared to patients who did not receive adjuvant chemotherapy, those with stage I SCLC or LCNEC who underwent adjuvant chemotherapy demonstrated a significantly improved DFS (P=0.005 and P=0.048) and OS (P=0.004 and P=0.03).
Conclusions: LCNEC and SCLC, as well as their subtypes, have distinct clinical features and survival outcomes. SCLC exhibited more malignant biological behavior and was associated with a worse prognosis compared to LCNEC. Postoperative chemotherapy is recommended for patients with stage I HGNEC.
期刊介绍：
The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, and indexed in PubMed in Dec 2011 and Science Citation Index SCI in Feb 2013. It is published quarterly (Dec 2009- Dec 2011), bimonthly (Jan 2012 - Dec 2013), monthly (Jan. 2014-) and openly distributed worldwide. JTD received its impact factor of 2.365 for the year 2016. JTD publishes manuscripts that describe new findings and provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease. All the submission and reviewing are conducted electronically so that rapid review is assured.
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