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

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

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

References

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