Treatment Outcomes of Patients With Different Subtypes of Large Cell Carcinoma of the Lung

Background. Although large cell neuroendocrine carcinoma (LCNEC) and lymphoepithelioma-like carcinoma (LELC) are the variants of large cell carcinoma (LCC) of lung, there are few studies comparing them. The aim of this study was to compare the clinical characteristic and treatment outcomes of LCNEC, LELC, and classic LCC. Methods. Patients with LCNEC, LELC, or classic LCC were identified in a prospectively collected database, and their data were analyzed. Results. A total of 46 patients with classic LCC, 30 with LCNEC, and 18 with LELC, who received surgical resection with curative intent, were identified and included in the analysis. Patients with LELC were younger, and the frequency of nonsmokers was greater than in patients with classic LCC or LCNEC. In patients with LCNEC or LELC, most lesions were located on the left side. There were 5 surgical deaths, and the median follow-up time of the surviving patients was 44.1 months. The 5-year disease free survival among the three subgroups was similar (p = 0.601), but patients with LELC had a significantly better overall survival than the other two subgroups (LELC vs classic LCC, p = 0.009; LELC vs LCNEC, p = 0.002). Multivariate analysis showed tumor location site, tumor stage, and LELC were independent prognostic factors of overall survival. Conclusions. The clinical manifestations and treatment outcomes of LCNEC, LELC, and classic LCC are different. LCNEC has a poor survival, and survival is not different than that of classic LCC. LELC is associated with younger age and a higher frequency of nonsmokers, and the treatment outcomes are better than those of other subtypes. (C) 2014 by The Society of Thoracic Surgeons