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Adjuvant Therapy for Patients With Early Large Cell Lung Neuroendocrine Cancer: A National Analysis.

Publication ,  Journal Article
Raman, V; Jawitz, OK; Yang, C-FJ; Tong, BC; D'Amico, TA; Berry, MF; Harpole, DH
Published in: Ann Thorac Surg
August 2019

BACKGROUND: Current guidelines do not routinely recommend adjuvant therapy for resected stage I large cell lung neuroendocrine cancer (LCNEC). However, data regarding the role of adjuvant therapy in early LCNEC are limited. This National Cancer Database (NCDB) analysis was performed to improve the evidence guiding adjuvant therapy for early LCNEC. METHODS: Overall survival (OS) of patients with pathologic T1-2a N0 M0 LCNEC who underwent resection in the NCDB from 2003 to 2015 was evaluated with Kaplan-Meier and multivariable Cox proportional hazards analyses. Patients who died within 30 days of surgery and with more than R0 resection were excluded. RESULTS: Of 2642 patients meeting study criteria, 481 (18%) received adjuvant therapy. Adjuvant chemotherapy in stage IB patients was associated with a significant increase in OS (hazard ratio, 0.67; 95% confidence interval, 0.50 to 0.90). However, there was no significant difference in survival between adjuvant chemotherapy and no adjuvant therapy for stage IA LCNEC (hazard ratio, 0.92; 95% confidence interval, 0.75 to 1.11). Adjuvant radiotherapy, whether alone or combined with chemotherapy, was not associated with a change in OS. In subgroup analysis, patients receiving adjuvant chemotherapy after lobar resection for stage IB LCNEC had a significant survival benefit compared with patients not receiving adjuvant therapy. CONCLUSIONS: In early-stage LCNEC, adjuvant chemotherapy appears to confer an additional overall survival advantage only in patients with completely resected stage IB LCNEC and not for patients with completely resected stage IA LCNEC.

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Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

August 2019

Volume

108

Issue

2

Start / End Page

377 / 383

Location

Netherlands

Related Subject Headings

  • United States
  • Treatment Outcome
  • Survival Rate
  • Retrospective Studies
  • Respiratory System
  • Radiotherapy, Adjuvant
  • Puerto Rico
  • Pneumonectomy
  • Neoplasm Staging
  • Middle Aged
 

Citation

APA
Chicago
ICMJE
MLA
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Raman, V., Jawitz, O. K., Yang, C.-F., Tong, B. C., D’Amico, T. A., Berry, M. F., & Harpole, D. H. (2019). Adjuvant Therapy for Patients With Early Large Cell Lung Neuroendocrine Cancer: A National Analysis. Ann Thorac Surg, 108(2), 377–383. https://doi.org/10.1016/j.athoracsur.2019.03.053
Raman, Vignesh, Oliver K. Jawitz, Chi-Fu J. Yang, Betty C. Tong, Thomas A. D’Amico, Mark F. Berry, and David H. Harpole. “Adjuvant Therapy for Patients With Early Large Cell Lung Neuroendocrine Cancer: A National Analysis.Ann Thorac Surg 108, no. 2 (August 2019): 377–83. https://doi.org/10.1016/j.athoracsur.2019.03.053.
Raman V, Jawitz OK, Yang C-FJ, Tong BC, D’Amico TA, Berry MF, et al. Adjuvant Therapy for Patients With Early Large Cell Lung Neuroendocrine Cancer: A National Analysis. Ann Thorac Surg. 2019 Aug;108(2):377–83.
Raman, Vignesh, et al. “Adjuvant Therapy for Patients With Early Large Cell Lung Neuroendocrine Cancer: A National Analysis.Ann Thorac Surg, vol. 108, no. 2, Aug. 2019, pp. 377–83. Pubmed, doi:10.1016/j.athoracsur.2019.03.053.
Raman V, Jawitz OK, Yang C-FJ, Tong BC, D’Amico TA, Berry MF, Harpole DH. Adjuvant Therapy for Patients With Early Large Cell Lung Neuroendocrine Cancer: A National Analysis. Ann Thorac Surg. 2019 Aug;108(2):377–383.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

August 2019

Volume

108

Issue

2

Start / End Page

377 / 383

Location

Netherlands

Related Subject Headings

  • United States
  • Treatment Outcome
  • Survival Rate
  • Retrospective Studies
  • Respiratory System
  • Radiotherapy, Adjuvant
  • Puerto Rico
  • Pneumonectomy
  • Neoplasm Staging
  • Middle Aged