Clinical features and treatment outcomes of resected large cell neuroendocrine carcinoma of the lung

Jin Young Moon, Seo Hee Choi, Tae Hyung Kim, Joongyo Lee, Ji Hoon Pyo, Yong Tae Kim, Seo Jin Lee, Hong In Yoon, Jaeho Cho, Chang Geol Lee

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2 Citations (Scopus)


Purpose: Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a high-grade lung neuroendo-crine tumor with a poor prognosis, similar to small cell lung cancer (SCLC). However, it remains un-clear whether to treat LCNEC as non-small-cell lung cancer (NSCLC) or as SCLC. We reviewed our ex-periences to suggest appropriate treatment strategy for resected pulmonary LCNEC. Materials and Methods: Forty-four patients were treated for pathologically diagnosed pulmonary LCNEC during 2005–2018. We considered curative surgery first in early-stage or some locally advanced tumors, unless medically inoperable. Adjuvant treatments were decided considering patient’s clinical and pathological features. After excluding two stage I tumors with radiotherapy alone and three stage III tumors with upfront chemotherapy, we analyzed 39 patients with stage I–III pulmonary LCNEC, who underwent curative resection first. Results: Adjuvant chemotherapy (NSCLC-based 91%, SCLC-based 9%) was performed in 62%, and adjuvant radiotherapy was done in three patients for pN2 or positive margin. None received prophy-lactic cranial irradiation (PCI). With a median follow-up of 30 months, the 2-and 5-year overall survival (OS) rates were 68% and 51%, and the 2-and 5-year recurrence-free survival (RFS) rates were 49% and 43%, respectively. Aged ≥67 years and SCLC-mixed pathology were significant poor prognostic factors for OS or RFS (p < 0.05). Among 17 recurrences, regional failures were most common (n = 6), and there were five brain metastases. Conclusions: Surgery and adjuvant treatment (without PCI) could achieve favorable outcomes in pulmonary LCNEC, which was more similar to NSCLC, although some factors worsened the prognosis. The importance of intensified adjuvant therapies with multidisciplinary approach remains high.

Original languageEnglish
Pages (from-to)288-296
Number of pages9
JournalRadiation Oncology Journal
Issue number4
Publication statusPublished - 2021 Dec

Bibliographical note

Funding Information:
This study was supported by a faculty research grant of Yonsei University College of Medicine for (No. 6-2020-0115).

Publisher Copyright:
© 2021 The Korean Society for Radiation Oncology.

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging


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