title: Surgical management of pulmonary large cell neuroendocrine carcinomas: a 10-year experience.
abstract: OBJECTIVE
  Large cell neuroendocrine carcinoma (LCNEC) represents a relatively rare and poorly studied entity whose management is not clearly established. The aim of this study was to assess clinico-pathological characteristics, treatment modalities and outcomes of LCNEC.
  
  
  METHODS
  A retrospective study of patients operated on for LCNEC between 2000 and 2010 was carried out.
  
  
  RESULTS
  Sixty-three patients (49 men, median age 64 years) with pathologically confirmed LCNEC of the lung were operated on between 2000 and 2010. Neoadjuvant chemotherapy was administered in 16 cases. Standard lobectomy, sleeve lobectomy, bilobectomy and pneumonectomy were performed in 63.5%, 9.5%, 1.6% and 15.8% of cases. There were two cases of extended resection. Sublobar resections were performed in four patients. Postoperative mortality was 1.6%. Postoperative staging was IA, IB, IIA, IIB, IIIA, IIIB and IV in 15.9%, 19%, 20.6%, 4.8%, 34.9%, 4.8% and 0% of cases, respectively. Adjuvant treatments were administered in 70% of cases. Overall 5-, and 8- year survival rates were 49.2% (37-61.6%) and 42% (28.8-56.4%), respectively. Multivariate analysis, including age >64 years, cumulative tobacco consumption, size of tumour, pT and pN parameters showed that only age (P = 0.05, RR 2.1 [0.99-4.43]) and pT parameter (P = 0.0078, RR 2.93[1.33-6.46]) were independent predictors of survival.
  
  
  CONCLUSIONS
  Surgery may achieve satisfactory results in terms of survival, in spite of the similarities of LCNEC with small cell lung cancer. Multimodality management seems necessary.
authors.affiliation: Departments of Thoracic Surgery and Pathology, Hôtel-Dieu University Hospital, Paris, France. ludfoul@hotmail.com
authors.forename: Ludovic
authors.initials: L
authors.lastname: Fournel
authors.forename: Pierre Emmanuel
authors.initials: PE
authors.lastname: Falcoz
authors.forename: Marco
authors.initials: M
authors.lastname: Alifano
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Charpentier
authors.forename: Mohamed-Sadok
authors.initials: MS
authors.lastname: Boudaya
authors.forename: Pierre
authors.initials: P
authors.lastname: Magdeleinat
authors.forename: Diane
authors.initials: D
authors.lastname: Damotte
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Régnard
mesh_terms: D000368:Aged; D018287:Carcinoma, Large Cell / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery*; D018278:Carcinoma, Neuroendocrine / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011013:Pneumonectomy; D012189:Retrospective Studies