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. 2023 Jul 5;18(1):216.
doi: 10.1186/s13019-023-02314-1.

The survival benefit from surgery on patients with large-cell neuroendocrine carcinoma in the lung: a propensity-score matching study

Hao Jiang  1 , Weixia Xie  2 , Xianpeng Li  3 , Huaying Wang  4 , Wan-Jun Yu  4 , Xiaolu Chen  4
Affiliations

The survival benefit from surgery on patients with large-cell neuroendocrine carcinoma in the lung: a propensity-score matching study

Hao Jiang et al. J Cardiothorac Surg. .

Abstract

Purpose: This study aimed to investigate the prognostic significance of surgery in large-cell neuroendocrine carcinoma (LCNC) patients.

Methods: A total of 453 patients from the Surveillance, Epidemiology, and End Results database diagnosed with stage T1-4N0-2M0 LCNC from 2010 to 2015 were analyzed. The propensity-score matching analysis with a ratio of 1:1 was used to minimize the bias effect of other clinical characteristics, and 77 pairs of patients' data were performed for subsequent statistical analysis. The Cox proportional hazards model, Kaplan-Meier analysis, and Log-rank test were used in the present study. The primary observational endpoint was cancer-specific survival (CSS).

Results: The 1-year, 3-year, and 5-year CSS rates were 60.0%, 45.0%, and 42.0% in those 453 LCNC patients. Compared with patients who underwent surgical resection, patients without surgery had a lower 5-year CSS rate (18.0% vs. 52.0%, P < 0.001). After analyses of multivariable Cox regression, chemotherapy, T stage, N stage, and surgery were identified as independent prognostic indicators (all P < 0.05). In the cohort of old patients, the median survival time was longer in cases after surgery than those without surgery (13.0 months vs. NA, P < 0.001). Besides, in patients with different clinical characteristics, the receiving surgery was a protective prognostic factor (all hazard ratio < 1, all P < 0.05). In addition, for the cohort with stage T1-2N0-2M0, patients after the operation had more improved outcomes than patients without surgery (P < 0.001).

Conclusions: We proposed that the surgery could improve the survival outcomes of LCNC patients with stage T1-4N0-2M0. Moreover, old patients could benefit from surgery.

Keywords: Large-cell neuroendocrine carcinoma; Propensity-score matching; Surgery; Survival.

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Conflict of interest statement

The authors have no competing interests to disclose.

Figures

Fig. 1
Fig. 1
The process of patient selection in this study
Fig. 2
Fig. 2
The cancer-specific survival curves in all patients (A) and matched cohort (B) based on surgery (no vs. yes)
Fig. 3
Fig. 3
The cancer-specific survival curves in old patients (A) and patients with stage T1-2N0-2M0 (B) based on surgery (no vs. yes)
See this image and copyright information in PMC

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