title: Effect of chemotherapy in patients with resected small-cell or large-cell neuroendocrine carcinoma.
abstract: BACKGROUND
  Surgical resection of an undiagnosed lung lesion may lead to unintentional removal of small-cell lung cancer (SCLC). The benefit of perioperative chemotherapy in resected SCLC or large-cell neuroendocrine carcinomas (LCNEC) is not clear.
  
  
  METHODS
  This retrospective analysis included limited disease SCLC and LCNEC that had been surgically removed between 1979 and 2007 at a single institution. Perioperative treatments were analyzed, and survival followed up. Log rank tests were used to compare overall survival.
  
  
  RESULTS
  Among 74 patients who had a tumor resection, 45 received chemotherapy, four had preoperative radiotherapy, and 21 had postoperative radiotherapy. Eleven patients were women. The median age was 64 in the surgery group and 58 in the surgery plus chemotherapy group, and four and 11 patients in these groups, respectively, had LCNEC. There were 10 node positive tumors and only two incomplete resections in the surgery group versus 27 node positive tumors and three incomplete resections in the surgery plus chemotherapy group. The median follow-up was shorter in the group with surgery alone: 4.5 years (1.4-7) versus 5.8 years (0.6-19.6). Among the patients with a survival or a follow-up of at least 6 months, the median survival was 2.3 and 6.1 years in the surgery (n = 20) and surgery plus chemotherapy (n = 39) groups, respectively, such that the hazard ratio for death was 0.48 (95% confidence interval, 0.24-0.99, p = 0.04).
  
  
  CONCLUSIONS
  These results suggest that perioperative chemotherapy may be beneficial in patients with resected SCLC or LCNEC.
authors.affiliation: Departments of Medicine and Biostatistics, Institut Gustave Roussy, Villejuif, France.
authors.forename: Nader
authors.initials: N
authors.lastname: Abedallaa
authors.forename: Lise
authors.initials: L
authors.lastname: Tremblay
authors.forename: Charlotte
authors.initials: C
authors.lastname: Baey
authors.forename: Dominique
authors.initials: D
authors.lastname: Fabre
authors.forename: David
authors.initials: D
authors.lastname: Planchard
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Pignon
authors.forename: Joel
authors.initials: J
authors.lastname: Guigay
authors.forename: Cécile Le
authors.initials: CL
authors.lastname: Pechoux
authors.forename: Jean Charles
authors.initials: JC
authors.lastname: Soria
authors.forename: Vincent Thomas
authors.initials: VT
authors.lastname: de Montpreville
authors.forename: Benjamin
authors.initials: B
authors.lastname: Besse
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018287:Carcinoma, Large Cell / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D018278:Carcinoma, Neuroendocrine / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009367:Neoplasm Staging; D019990:Perioperative Care; D010984:Platinum / Q000008:administration & dosage; D011013:Pneumonectomy; D011379:Prognosis; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D015996:Survival Rate
chemical_list: D010984:Platinum; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D007069:Ifosfamide; D008727:Methotrexate