Sınıflandırılamayan akciğer yüksek dereceli nöroendokrin karsinomaların klinik özellikleri ve sağ kalım sonuçları

Year 2023, Volume: 13 Issue: 2, 295 - 304, 30.06.2023

Yasemin Söyler , Pınar Akın Kabalak , Suna Kavurgacı , Funda Demirağ , Ülkü Yılmaz

https://doi.org/10.31832/smj.1277259

Abstract

Amaç: Bu çalışmanın amacı patolojik olarak tiplendirilemeyen yüksek dereceli nöroendokrin karsinomların (uYDNEK) klinik özelliklerini ve sağ kalım sonuçlarını değerlendirmek ve küçük hücreli akciğer kanseri (KHAK) ile karşılaştırmaktır.
Yöntem ve Gereçler: Bu retrospektif ve gözlemsel çalışmada YDNEK hastalarının klinik özellikleri değerlendirildi. Progresyonsuz sağkalım (PFS) ve genel sağkalım (OS) Kaplan-Meier yöntemi kullanılarak hesaplandı. PFS ve OS ile ilişkili bağımsız risk faktörlerini belirlemek için Cox-regresyon analizleri yapıldı.
Bulgular: Çalışmaya 121 hasta [uYDNEK (n=35), KHAK (n=86)] dahil edildi. Primer tümör çoğunlukla sağ tarafta ve santral yerleşimliydi. Tanı anındaki evre 43 (%35,5) hastada lokal ileri, 78 (%64,5) hastada ileri idi. uYDNEK ve KHAK grupların klinik özellikleri benzerdi. Çalışma popülasyonunun medyan PFS ve OS'si sırasıyla 8,8 (%95 Cl 7,29 – 10,30) ve 10,9 (%95 Cl 9,9 – 11,8) ay olarak hesaplandı. uYDNEK ve KHAK grupları arasında PFS (9.4 ve 8.6 ay, p = 0.99) ve OS (12 ve 10.7 ay, p = 0.51) istastistiksel olarak benzer bulundu. 6-aylık, 1-yıllık, 2-yıllık PFS ve OS hesaplandı, 2 grup arasında istatistiksel fark bulunmadı. Cox regresyon analizinde primer tümörün sağ tarafta yerleşimi (HR: 1.558, 95%Cl 1.044 – 2.325, p = 0.03) ve ileri evre hastalık (HR: 1.928, 95%Cl 1.292 – 2.877, p = 0.001) OS için kötü prognostik faktör olarak bulundu. Cox regresyon analizinin sonuçları, histopatolojik alt tiplerin PFS ve OS üzerinde bir etkisinin olmadığını gösterdi.
Sonuç: Patolojik olarak sınıflandırılamayan YDNEK hastaları KHAK hastaları ile benzer klinik ve sağ kalım özellikleri göstermektedir.

Keywords

yüksek dereceli nöroendokrin karsinoma, küçük hücreli akciğer kanseri, nöroendokrin tümörler

Project Number

None

Clinical features and survival outcomes of unclassified high-grade neuroendocrine carcinoma of the lung

Abstract

Background: Differentiating high-grade neuroendocrine carcinomas (HGNEC) is difficult. We aimed to assess the clinical features and survival outcomes of unclassified HGNEC (uHGNEC) and to compare it with small-cell lung cancer (SCLC).
Material and Methods: This was a retrospective and observational study of HGNEC patients. Kaplan-Meier method was used to estimate progression-free survival (PFS) and overall survival (OS). Cox-regression analyses were used to determine the risk factors independently associated with PFS and OS.
Results: One hundred twenty-one patients [uHGNEC (n = 35), SCLC (n = 86)] were analysed. The primary tumour was mostly right-sided, located in the centre of the lungs. The IASLC stage at diagnosis was locally advanced in 43 (35.5%) patients and advanced in 78 (64.5%) patients. uHGNEC and SCLC groups shared similar clinical features. The study population's median PFS and OS were 8.8 (95%Cl 7.29 – 10.30) and 10.9 (95%Cl 9.9 – 11.8) months, respectively. uHGNEC- and SCLC groups had a similar PFS (9.4 vs 8.6 months, p = 0.99) and OS (12 vs 10.7 months, p = 0.51). The six-month, one- and two-year PFS and OS of two groups were also similar. Among all patients, a right-sided tumour (HR: 1.558, 95%Cl 1.044 – 2.325, p = 0.03) and advanced-stage disease (HR: 1.928, 95%Cl 1.292 – 2.877, p = 0.001) were prognostic factors for poor OS. Cox-regression analysis indicated that histopathology did not have an impact on PFS and OS.
Conclusion: HGNEC patients who cannot be classified pathologically behave like SCLC.

Keywords

high-grade neuroendocrine carcinoma, pulmonary neuroendocrine carcinomas, small-cell lung cancer

Supporting Institution

None

Project Number

None

Thanks

None

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