Abstract：
BACKGROUND: Large cell neuroendocrine carcinoma (LCNEC) of the lung is a rare, aggressive cancer most commonly found in the lungs but not exclusively, with a worse prognosis than non-small cell lung carcinomas. Currently, LCNEC patients are treated using small cell and non-small cell protocols. This study aims to use the SEER database to identify demographic, clinical, pathological, and therapeutic factors affecting the prognosis and survival of patients with LCNEC of the lung.
METHODS: Demographic, clinical, and management data of patients with lung LCNEC were extracted from the SEER database for the period 2000-2018.
RESULTS: In the USA, LCNEC has a higher incidence in elderly white men: M:F ratio = 1.2:1, Caucasian: 83.3%, mean age: 67 ± 10.2 years. The most common treatment modality was chemotherapy only: 29.2%, followed by surgery: 21.5% (but in this group the statuses of chemotherapy were unknown), and combination surgery/chemotherapy: 8.8%. The overall and cause-specific 5-year survival was 17.5% (95% CI 16.3-18.8) and 21.9% (95% CI 20.5-23.4), respectively. By treatment, the best 5-year survival was for surgery alone (48%), followed by multimodality therapy (chemo + surgery + radiation) at 35% (95% CI 27-43). Age > 60 years, male gender, size > 7 cm, and nodal and liver metastasis were independent risk factors associated with increased mortality.
CONCLUSIONS: Lung LCNEC is an aggressive neoplasm most common in older white males that presents at an advanced stage despite small primary tumors. Most patients die within 2 years. The best predictor of survival is surgery with chemotherapy. Given its dismal prognosis, new treatment guidelines are needed for this aggressive cancer.
METHODS: Demographic, clinical, and management data of patients with lung LCNEC were extracted from the SEER database for the period 2000-2018.
RESULTS: In the USA, LCNEC has a higher incidence in elderly white men: M:F ratio = 1.2:1, Caucasian: 83.3%, mean age: 67 ± 10.2 years. The most common treatment modality was chemotherapy only: 29.2%, followed by surgery: 21.5% (but in this group the statuses of chemotherapy were unknown), and combination surgery/chemotherapy: 8.8%. The overall and cause-specific 5-year survival was 17.5% (95% CI 16.3-18.8) and 21.9% (95% CI 20.5-23.4), respectively. By treatment, the best 5-year survival was for surgery alone (48%), followed by multimodality therapy (chemo + surgery + radiation) at 35% (95% CI 27-43). Age > 60 years, male gender, size > 7 cm, and nodal and liver metastasis were independent risk factors associated with increased mortality.
CONCLUSIONS: Lung LCNEC is an aggressive neoplasm most common in older white males that presents at an advanced stage despite small primary tumors. Most patients die within 2 years. The best predictor of survival is surgery with chemotherapy. Given its dismal prognosis, new treatment guidelines are needed for this aggressive cancer.
摘要：
背景：肺大细胞神经内分泌癌（LCNEC）是一种罕见的，侵袭性癌症最常见于肺部，但不限于此，预后比非小细胞肺癌差。目前,使用小细胞和非小细胞方案治疗LCNEC患者。本研究旨在使用SEER数据库来识别人口统计，临床,病态,以及影响肺LCNEC患者预后和生存的治疗因素。
方法：人口统计学，临床,我们从SEER数据库中提取了2000-2018年肺部LCNEC患者的管理数据.
结果：在美国，LCNEC在老年白人男性中的发病率较高：M：F比率=1.2：1，白种人：83.3％，平均年龄：67±10.2岁。最常见的治疗方式仅是化疗：29.2%，其次是手术：21.5％（但该组的化疗状态未知），联合手术/化疗：8.8%。总体和病因特异性5年生存率分别为17.5%（95%CI16.3-18.8）和21.9%（95%CI20.5-23.4），分别。通过治疗,最好的5年生存率是单独手术（48%），其次是多模式治疗（化疗+手术+放疗），占35%（95%CI27-43）。年龄>60岁，男性,尺寸>7厘米，淋巴结转移和肝转移是增加死亡率的独立危险因素。
结论：肺LCNEC是一种侵袭性肿瘤，最常见于老年白人男性，尽管原发性肿瘤较小，但仍处于晚期。大多数患者在2年内死亡。生存的最佳预测指标是手术加化疗。鉴于其令人沮丧的预后，这种侵袭性癌症需要新的治疗指南.
方法：人口统计学，临床,我们从SEER数据库中提取了2000-2018年肺部LCNEC患者的管理数据.
结果：在美国，LCNEC在老年白人男性中的发病率较高：M：F比率=1.2：1，白种人：83.3％，平均年龄：67±10.2岁。最常见的治疗方式仅是化疗：29.2%，其次是手术：21.5％（但该组的化疗状态未知），联合手术/化疗：8.8%。总体和病因特异性5年生存率分别为17.5%（95%CI16.3-18.8）和21.9%（95%CI20.5-23.4），分别。通过治疗,最好的5年生存率是单独手术（48%），其次是多模式治疗（化疗+手术+放疗），占35%（95%CI27-43）。年龄>60岁，男性,尺寸>7厘米，淋巴结转移和肝转移是增加死亡率的独立危险因素。
结论：肺LCNEC是一种侵袭性肿瘤，最常见于老年白人男性，尽管原发性肿瘤较小，但仍处于晚期。大多数患者在2年内死亡。生存的最佳预测指标是手术加化疗。鉴于其令人沮丧的预后，这种侵袭性癌症需要新的治疗指南.
