Large cell neuroendocrine carcinoma of the lung: An aggressive disease potentially treatable with surgery

被引:37
作者
Doddoli, C
Barlesi, F
Chetaille, B
Garbe, L
Thomas, P
Giudicelli, R
Fuentes, P
机构
[1] Univ Mediterranee Aix Marseille 2, Fac Med, St Marguerite Hosp, Assistance Publ,Hop Marseille,Dept Thorac Surg, Marseille, France
[2] Univ Mediterranee Aix Marseille 2, Fac Med, St Marguerite Hosp, Assistance Publ,Hop Marseille,Dept Thorac Oncol, Marseille, France
[3] Univ Mediterranee Aix Marseille 2, Fac Med, St Marguerite Hosp, Assistance Publ,Hop Marseille,Dept Pathol, Marseille, France
关键词
D O I
10.1016/j.athoracsur.2003.09.049
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Assessment of clinical and pathologic features of large cell neuroendocrine carcinoma to confirm its specificity in the setting of high grade neuroendocrine pulmonary tumors. Methods. From 1989 to 2001, 123 patients with a neuroendocrine carcinoma were surgically treated in a curative intent at a single institution. According to the 1999 World Health Organization classification, 20 patients were reviewed as having a large cell neuroendocrine carcinoma. Clinical data as well as detailed pathologic analysis and survival were collected. Results. There were 18 men and 2 women. The median age was 62 years. Four patients had a preoperative diagnosis of large cell neuroendocrine carcinoma. The resections consisted of 14 lobectomies and 6 pneumonectomies. There was no operative death. Complications occurred in 7 patients (35%). Four patients had a stage I of the disease, 4 had stage 11, 9 had stage 111, and 3 had stage IV. At follow-up (median, 46 months), 13 patients died from general recurrence and 7 patients were still alive. Median time to progression was 9 months (range, 1 to 54 months). The 5-year survival rate was 36% (median, 49 months) and it seemed to be negatively influenced by the disease stage (54% for stage I-II vs 25% for stage III-IV; p = 0.07), the presence of metastatic lymph node (45% for N0/N1 vs 17% for N2; p = 0.12), or vessel invasion (66 vs 25%; p = 0.18). Conclusions. Large cell neuroendocrine carcinoma predominantly occurred in men. An accurate tissue diagnosis was rarely obtained preoperatively. Although overall survival after resection was substantial, large cell neuroendocrine carcinoma frequently showed pathologic features of occult metastatic disease, such as lymph node or vessel invasion, or both.
引用
收藏
页码:1168 / 1172
页数:5
相关论文
共 23 条
[1]   The P16/cyclin D1/Rb pathway in neuroendocrine tumors of the lung [J].
Beasley, MB ;
Lantuejoul, S ;
Abbondanzo, S ;
Chu, WS ;
Hasleton, P ;
Travis, WD ;
Brambilla, E .
HUMAN PATHOLOGY, 2003, 34 (02) :136-142
[2]  
Brambilla E, 1996, AM J PATHOL, V149, P1941
[3]  
Brechot JM, 1996, CANCER-AM CANCER SOC, V78, P2111, DOI 10.1002/(SICI)1097-0142(19961115)78:10<2111::AID-CNCR11>3.0.CO
[4]  
2-1
[5]   Diagnostic and therapeutic management of neuroendocrine lung tumors - A clinical study of 44 cases [J].
Carretta, A ;
Ceresoli, GL ;
Arrigoni, G ;
Canneto, B ;
Reni, M ;
Cigala, C ;
Zannini, P .
LUNG CANCER, 2000, 29 (03) :217-225
[6]   The surgical spectrum of pulmonary neuroendocrine neoplasms [J].
Cooper, WA ;
Thourani, VH ;
Gal, AA ;
Lee, RB ;
Mansour, KA ;
Miller, JI .
CHEST, 2001, 119 (01) :14-18
[7]   Is lung cancer surgery justified in patients with direct mediastinal invasion? [J].
Doddoli, C ;
Rollet, G ;
Thomas, P ;
Ghez, O ;
Serée, Y ;
Giudicelli, R ;
Fuentes, P .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2001, 20 (02) :339-343
[8]   Study of prognostic predictors for non-small cell lung cancer [J].
Fu, XL ;
Zhu, XZ ;
Shi, DR ;
Xiu, LZ ;
Wang, LJ ;
Zhao, S ;
Qian, H ;
Lu, HF ;
Xiang, YB ;
Jiang, GL .
LUNG CANCER, 1999, 23 (02) :143-152
[9]  
Huang Q, 2002, ARCH PATHOL LAB MED, V126, P545
[10]   Pulmonary large cell carcinomas with neuroendocrine features are high-grade neuroendocrine tumors [J].
Iyoda, A ;
Hiroshima, K ;
Baba, M ;
Saitoh, Y ;
Ohwada, H ;
Fujisawa, T .
ANNALS OF THORACIC SURGERY, 2002, 73 (04) :1049-1054