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Ann Thorac Surg 2004;77:1163-1167
© 2004 The Society of Thoracic Surgeons

Original article: general thoracic

Large cell neuroendocrine carcinoma of the lung: a 10-year clinicopathologic retrospective study

Massimiliano Paci, MDa*, Alberto Cavazza, MDb, Valerio Annessi, MDa, Innocenza Putrino, MDb, Guglielmo Ferrari, MDa, Salvatore De Franco, MDa, Giorgio Sgarbi, MDa

a Division of Thoracic Surgery, Santa Maria Nuova Hospital, Reggio Emilia, Italy
b Department of Pathology, Santa Maria Nuova Hospital, Reggio Emilia, Italy

Accepted for publication September 5, 2003.

* Address reprint requests to Dr Paci, Division of Thoracic Surgery, Santa Maria Nuova Hospital, Viale Risorgimento 80, 42100 Reggio Emilia, Italy
e-mail: paci.massimiliano{at}asmn.re.it

BACKGROUND: Large cell neuroendocrine carcinoma is a recently recognized histologic entity whose clinical features and optimal treatment have not yet been well defined and are still being assessed. We report our retrospective assessment of cases of large cell neuroendocrine carcinoma observed from 1989 to 1999 in terms of survival.

METHODS: Cases of large cell neuroendocrine carcinoma diagnosed between 1989 and 1999 were reassessed retrospectively according to the World Health Organization classification. The clinical outcome and pathologic features of all cases are described. Survival rates of patients with large cell neuroendocrine carcinoma are compared with those patients with small cell lung cancer treated in the same period.

RESULTS: Patients were 41 men and 7 women with an average age of 63.7 years. Twenty-nine patients (60.4%) had pathologic stage I disease, 11 patients (22.9%) had pathologic stage II disease, and 7 patients (14.6%) had pathologic stage IIIA disease. One patient (2.1%) had pathologic stage IIIB disease. No patient underwent induction chemotherapy. Two patients underwent adjuvant chemotherapy and 2 underwent mediastinal radiotherapy for N2. No death was reported in the perioperative period. The median follow-up was 5 years. The actuarial survival for the entire group was 60.4% at 1 year, 27.5% at 3 years, and 21.2% at 5 years. The actuarial survival of accurately staged, stage I patients at 5 years was 27%.

CONCLUSIONS: The findings suggest that treating large cell neuroendocrine carcinoma by means of applying treatment for nonsmall cell lung cancer leads to a prognosis that is worse than that for nonsmall cell lung cancer, even in terms of low pathologic stages.




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