Large cell neuroendocrine carcinoma of the lung: pathological study and clinical outcome of 18 resected cases

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

“…It is difficult to perform transbronchial biopsy on these usually peripheral tumors and cytology with immunohistochemistry on fine needle biopsy is not sufficient to accurately diagnose these tumors [7]. In our series, the patients with LCNEC represented 3.5% of all patients undergoing surgery for pulmonary neoplasm.…”

“…The recurrence rate in the literature is 57% [15]. In a series of patients described by Maziè res [7], the response to cisplatin-based chemotherapy was 20% and partial. This pathology is therefore to be considered as having a high grade of malignancy.…”

“…Induction chemotherapy was not carried out in our series of patients. Given the extreme histologic, immunohistochemical, and molecular similarity [16] between LCNEC and SCLC and the fact that LCNEC's clinical outcome is more similar to that of SCLC than to that of NSCLC, we wonder whether pathologists' interpretive difficulty has a real clinical effect and whether it might not be better to define a new therapeutic course that differs from that for NSCLC, for example one that foresees a combined modality treatment for each clinical case even when chemosensitivity seems lower than that in SCLC [7], with resistance attributed to the high frequency of MDR 1 gene expression [17]. In NSCLC patients NE differentiation appears to be an independent prognostic factor in terms of chemotherapy response [18].…”

“…Few studies have been done on adjuvant chemotherapy and these do not demonstrate improved survival rates [15]. The presence of lymph node involvement, mitotic rate, or the presence of molecular anomalies such as p53 and Bcl-2 do not seem to be correlated to clinical outcome [7]. Adjuvant radiotherapy seems to be effective in controlling the disease locally [7].…”

“…The presence of lymph node involvement, mitotic rate, or the presence of molecular anomalies such as p53 and Bcl-2 do not seem to be correlated to clinical outcome [7]. Adjuvant radiotherapy seems to be effective in controlling the disease locally [7]. Some authors [14] have suggested classifying LCNEC and SCLC in one group called "high-grade malignant neuroendocrine tumors" and using this biological information to define the treatment program.…”