Original articleGeneral thoracicProspective Study of Adjuvant Chemotherapy for Pulmonary Large Cell Neuroendocrine Carcinoma
Section snippets
Patients and Methods
The study was a one-arm, nonrandomized clinical study of primary pulmonary LCNEC patients whose tumors were resected surgically at Chiba University Hospital and Chiba Cancer Center between October 2000 and April 2005. LCNEC has evidence of neuroendocrine differentiation detected by immunohistochemistry or electron microscopy and the following neuroendocrine morphologic features: (1) neuroendocrine morphology such as organoid nesting, palisading, rosettes, and trabeculae; (2) a high mitotic rate
Results
Between October 2000 and April 2005, we treated 22 patients with LCNEC. Of these, 7 patients were excluded from the study because of incomplete resection, renal dysfunction, early recurrence, or no informed consents. In the prospective arm, therefore, 15 men with LCNEC were enrolled in the adjuvant chemotherapy group. These patients received a lobectomy with lymph node dissection followed by adjuvant chemotherapy consisting of CDDP and VP-16. Thirteen of the study subjects completed 2 courses
Comment
In general, the curative treatment for patients with non-SCLC is surgical resection. Pelosi and colleagues [9], however, reported that stage 1 adenocarcinomas with neuroendocrine differentiation were clinically aggressive tumors, and Hiroshima and colleagues [10] reported that stage 1 adenocarcinomas with neuroendocrine differentiation had a particularly poor prognosis. Previously, we reported [3] that patients with LCNEC features had a significantly poorer prognosis than patients with classic
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