Risk factors associated with survival in surgically treated large cell neuroendocrine carcinoma of the lung.

Introduction: Pulmonary large cell neuroendocrine carcinomas (LCNEC) are one of the rare malignant neoplasms of the lung. A standard management model for LCNEC has not yet been established and the poor prognostic factors and treatment modalities are still uncertain.

Aim: LCNEC are fairly rare and have a poor prognosis. Determination of the risk factors associated with survival can contribute to its management.

Material and methods: In this retrospective study, we analyzed the data of 42 patients. We obtained the data about the age, gender, smoking history, symptoms, tumor size, tumor location, pathological type, TNM stage, treatments, surgical modality, length of hospital stay, postoperative complications, disease-free survival and total survival from the hospital electronic files of the patients. Then we analyzed the relationship between these data and survival.

Results: 40 (95.24%) were male, and the mean age was 64.26 ±8.62. 12 (28.57%) patients were in stage I, 14 (33.3%) were in stage II, 15 (35.71%) were in stage III and only 1 (2.38%) patient was in stage IV. 15 (35.71%) had sublobar resection (wedge resection (n = 13) + segmentectomy (n = 2), 24 (57.14%) had lobectomy and 3 (7.14%) had pneumonectomy. The mean overall survival (OS) time was 34.86 ±30.11 months. 1-year, 3-year and 5-year survival rates of the patients were 73.80%, 47.61% and 19.04%, respectively. T stage (HR = 8.956, 95% CI: 1.521-11.034, p = 0.005) N stage (HR = 5.984, 95% CI: 1.127-7.982, p = 0.028) were independent risk factors for OS.

Conclusions: The overall survival in LCNEC was poor and the tumor size and the nodal stage were independent risk factors for overall survival.