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Ann Thorac Surg 2006;82:1802-1807
© 2006 The Society of Thoracic Surgeons

Original Articles: General Thoracic

Prospective Study of Adjuvant Chemotherapy for Pulmonary Large Cell Neuroendocrine Carcinoma

Akira Iyoda, MDa, Kenzo Hiroshima, MDb, Yasumitsu Moriya, MDa, Yuichi Takiguchi, MDc, Yasuo Sekine, MDa, Kiyoshi Shibuya, MDa, Toshihiko Iizasa, MDa, Hideki Kimura, MDd, Yukio Nakatani, MDb, Takehiko Fujisawa, MDa,*

a Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
b Department of Diagnostic Pathology, Graduate School of Medicine, Chiba University, Chiba, Japan
c Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
d Division of Thoracic Diseases, Chiba Cancer Center, Chiba, Japan

Accepted for publication May 22, 2006.

* Address correspondence to Dr Fujisawa, Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670 Japan. (Email: fujisawat{at}faculty.chiba-u.jp).

BACKGROUND: Patients with pulmonary large cell neuroendocrine carcinoma (LCNEC) have a very poor prognosis, but the benefit of adjuvant chemotherapy for these patients has not been established. We performed a prospective analysis of adjuvant chemotherapy for patients with completely resected pulmonary LCNECs to assess the effect of adjuvant chemotherapy.

METHODS: The adjuvant mixture consisted of cisplatin and VP-16 and was administered after surgery to 15 patients with LCNECs from 2000 to 2005. We compared patient survival with historical data for LCNEC patients treated without platinum-based adjuvant chemotherapy after surgery.

RESULTS: There were no differences in age, gender, surgical methods, and staging between the adjuvant chemotherapy group and the control group. Median follow-up was 33 months for the adjuvant group and 42 months for the control group. Of the 15 patients in the adjuvant chemotherapy group, 2 patients had disease recurrence and 1 died of interstitial pneumonia. The overall survival rate at 2 and 5 years of patients with adjuvant chemotherapy was 88.9%. The overall survival rate between patients with adjuvant chemotherapy and the historical control group was significantly different.

CONCLUSIONS: Adjuvant chemotherapy consisting of cisplatin and VP-16 after surgery appears promising for the improvement of the prognosis for patients with completely resected LCNECs, and it should be evaluated further in larger multi-institutional trials.


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