Prognostic factors for surgically resected pulmonary large cell neuroendocrine carcinoma: A single-institution real-world experience.

• DOI: 10.1200/jco.2025.43.16_suppl.e20033
• Publication Date: 2025-05-28T13:29:58Z
• Authors: Aman Wang; Henan Qin; Zhen Ning; Jiwei Liu
• Keywords: Neuroendocrine carcinoma

e20033 Background: Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare, highly aggressive malignancy with poor prognosis, accounting for approximately 3% of all lung cancers. LCNEC exhibits features both small-cell cancer (SCLC) and non-small-cell (NSCLC), complicating diagnosis treatment strategies. This study aims to identify clinical characteristics prognostic factors in patients following surgery resection. Methods: retrospective evaluated 44 histologically confirmed who underwent surgical resection between July 2016 January 2024 at the First Affiliated Hospital Dalian Medical University (Table 1). We analyzed features, interventions, pathology immunohistochemistry, TNM stage, perioperative treatment. Kaplan-Meier survival curves Cox regression models were used disease-free (DFS) overall (OS). Results: The median DFS was 26.0 months (range 18.5-40.0 months), OS 77.0 50.4-96.5 months). 2-year 3-year rates 59.09% 36.1%, respectively. Univariate analysis revealed that pure (DFS HR: 0.224, p =0.007; 0.281 =0.003), P53 mutation 0.183, =0.035; 0.230 =0.049), adjuvant chemotherapy EP/EC 0.372 =0.034; 0.292p =0.002) significantly associated improved OS. Multivariate identified LCNEC, p53 mutation, therapy as independent better DFS. Conclusions: Our highlights favorable multivariate Factors Hazard ratio (95% CI) P value Gender (male/female) 0.888 (0.210 - 3.755) 0.872 Age (<60 vs. ≥60) 0.586 (0.204 1.684) 0.321 Smoking history (yes no) 0.935 (0.453 1.929) 0.856 CEA (>1.70ng/ml) 0.979 (0.435 2.204) 0.960 NSE (>12.28ng/ml) 0.948 (0.223 4.036) 0.943 Cyfra211 (>2.70ng/ml) 0.730 (0.270 1.974) 0.535 pro-GRP (>35.77pg/ml) 0.511 (0.159 1.636) 0.258 Histology (Pure Combined) (0.122 0.646) 0.003 0.426 (0.171 1.060) 0.066 Ki-67 (≥30% <30%) 1.021 (0.287 3.629) 0.975 (Mutation Wild) (0.045- 0.986) 0.049 0.551 1.493) 0.242 Vascular thrombus 1.159 (0.470 2.856) 0.749 Pleural Invasion 2.507 (1.150 5.464) 0.021 0.528 (0.192 1.447) 0.214 Tumor size (>3cm ≤3cm) 1.408 (0.649 3.055) 0.386 Lymph node metastasis 1.348 (0.619 2.934) 0.452 Chemotherapy (EP/EC Others) 0.292 (0.135 0.632) 0.002 1.621 (0.678 3.877) 0.278 Thoracic Radiotherapy 0.420 (0.136 1.297) 0.131 Prophylactic cranial irradiation