2024 World Conference on Lung Cancer (WCLC) - Posters-P3.13E.02 Adjuvant Chemotherapy in cT1N0M0 Large-Cell Neuroendocrine Cancer with or without Pathological Upstaging

P3.13E.02 Adjuvant Chemotherapy in cT1N0M0 Large-Cell Neuroendocrine Cancer with or without Pathological Upstaging

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The study conducted a retrospective analysis at a single institution, examining outcomes for patients with clinical T1N0M0 large-cell neuroendocrine cancer (LCNEC) of the lung, focusing on tumor upstaging and the potential benefits of adjuvant chemotherapy. LCNEC, a rare and aggressive cancer type, is a neuroendocrine tumor akin to carcinoid and small cell lung cancer, with a reported incidence of 2.1% to 3.5% among lung tumors. Because of the poor prognosis associated with LCNEC, the efficacy of adjuvant chemotherapy remains a debated topic, especially for early-stage disease, due to inconclusive data.<br /><br />The study covered patients who underwent lobectomy or sublobar resection between 2002 and 2022. It categorized them based on pathological upstaging into T-upstage, N-upstage, and No-upstage groups. Key findings highlighted that upstaging was common, with occult node metastasis adversely affecting prognosis.<br /><br />Adjuvant chemotherapy was given to 35 (36.5%) of the patients and was associated with significantly improved recurrence-free survival (RFS). Specifically, median RFS was 64.1 months with adjuvant chemotherapy compared to 19.4 months without it. This survival benefit persisted across various subgroups but did not reach statistical significance in the T-upstage group. Importantly, even in patients without pathological upstage (T1N0M0), those receiving chemotherapy showed significantly longer RFS (107.2 vs 18.5 months).<br /><br />Despite the study's limitations, such as its retrospective nature and small dataset, it suggests potential benefits of adjuvant chemotherapy in very early-stage LCNEC, indicating a need for further research to confirm these findings and guide clinical practice.

Asset Subtitle

Yota Suzuki

Meta Tag

Speaker Yota Suzuki

Topic SCLC & Neuroendocrine Tumors

Keywords

LCNEC

lung cancer

adjuvant chemotherapy

retrospective analysis

tumor upstaging

recurrence-free survival

neuroendocrine tumor

lobectomy

sublobar resection

occult node metastasis