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Complexity in the treatment of pulmonary large cell neuroendocrine carcinoma

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Abstract

Purpose

According to the World Health Organization (WHO) classification of pulmonary large cell neuroendocrine carcinoma (LCNEC), one of the neuroendocrine tumors of the lung, is considered as a variant of non-small cell lung carcinoma. The objective of this study was to investigate the treatment strategy for LCNEC.

Methods

We retrospectively reviewed the clinical information of 12 patients with LCNEC.

Results

Three patients with stage I disease underwent curative resection but all relapsed within 20 months. One with stage IIA disease underwent non-curative resection received adjuvant chemoradiotherapy (cisplatin plus etoposide) and is well with no evidence of recurrence. Two with stage IIIB disease received concurrent chemoradiotherapy. Both achieved partial response (PR) but relapsed within 2 months. One elderly patient with stage IIIA disease received vinorelbine alone and did not respond. Of five patients with stage IV disease, three received platinum-based chemotherapy but no patient achieved PR. Of five patients with gefitinib as salvage therapy, one achieved PR.

Conclusions

The prognosis of LCNEC is poor. To improve the outcome, we must evaluate the effectiveness of adjuvant or neoadjuvant therapy in patients with resectable disease. In addition, the evaluation of systemic and multimodality treatment strategies similar as in small cell lung cancer is worthy of consideration.

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Acknowledgement

We thank Drs. Tadashi Yoshino, Department of Pathology, Okayama University Graduate School of Medicine and Density, Okayama, Japan and Yoshihiro Matsuno, Clinical Laboratory Division, National Cancer Center Research Institute and Hospital, Tokyo, Japan, for reviewing the case 3 that is the first case recognized as LCNEC in our institute

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Authors and Affiliations

  1. Department of Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, 700-8558, Okayama , Japan

    Katsuyuki Kiura & Masahiro Tabata

  2. Department of Hematology, Oncology and Respiratory Medicine (Department of Internal Medicine II), Okayama University Graduate School of Medicine and Density, Okayama, Japan

    Toshiyuki Kozuki, Nobukazu Fujimoto, Hiroshi Ueoka, Keiichi Fujiwara & Mitsune Tanimoto

  3. Department of Pathology, Okayama University Hospital, Okayama, Japan

    Shuji Hamazaki

  4. Kagawa Rosai Hospital, Kagawa, Japan

    Katsuhiko Shiomi & Koichi Mizobuchi

Authors
  1. Toshiyuki Kozuki
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  2. Nobukazu Fujimoto
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  3. Hiroshi Ueoka
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  4. Katsuyuki Kiura
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  5. Keiichi Fujiwara
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  6. Katsuhiko Shiomi
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  7. Koichi Mizobuchi
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  8. Masahiro Tabata
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  9. Shuji Hamazaki
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  10. Mitsune Tanimoto
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Correspondence to Katsuyuki Kiura.

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Kozuki, T., Fujimoto, N., Ueoka, H. et al. Complexity in the treatment of pulmonary large cell neuroendocrine carcinoma. J Cancer Res Clin Oncol 131, 147–151 (2005). https://doi.org/10.1007/s00432-004-0626-z

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  • DOI: https://doi.org/10.1007/s00432-004-0626-z

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