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Yoshimasa Maniwa

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    P1.12 - Small Cell Lung Cancer/NET (Not CME Accredited Session) (ID 944)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.12-05 - Efficacy of Perioperative Chemotherapy for High-Grade Neuroendocrine Tumors (ID 13135)

      16:45 - 18:00  |  Author(s): Yoshimasa Maniwa

      • Abstract
      • Slides


      Large-cell neuroendocrine carcinoma (LCNEC) and small-cell lung cancer (SCLC) are categorized as high-grade neuroendocrine tumors (HGNECs). There have been few studies to show the efficacy of perioperative chemotherapy for HGNEC as a single entity.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We retrospectively reviewed the medical records of patients who underwent tumor resection and were diagnosed with HGNECat Hyogo Cancer Center (Akashi, Japan) and Kobe University Hospital (Kobe, Japan)between January 2001 and December 2016. Overall survival (OS) was estimated by the Kaplan–Meier method. Multivariate analyses using a Cox proportional hazards model were performed to search for prognostic factors for HGNEC. Propensity score matching was performed to compare the OS between the treatment groups.

      4c3880bb027f159e801041b1021e88e8 Result

      We identified 197 patients who underwent surgery and who were diagnosed with HGNEC. Forty-three patients were excluded for the following reasons: pathological stage 4 or incomplete resection (n=25), synchronous multiple cancers (n=14), and insufficient medical records (n=5) We finally analyzed 153 HGNEC patients (LCNEC n=95, SCLC n=58). Seventy patients (LCNEC n=34, SCLC n=36) received perioperative chemotherapy. All of them received a platinum-based anticancer drug, and 80% received combined treatment with irinotecan or etoposide (n=56). The 5-year OS rates of the surgery plus chemotherapy and surgery alone groups were 75.5% and 34.7% (P<0.01), respectively. The HR for death in the surgery plus chemotherapy group was 0.34 (95% CI 0.20-0.56; P<0.01) in comparison to the surgery alone group. The multivariate analysis revealed that perioperative chemotherapy (HR 0.30, P<0.01), sublobar resection (HR 2.04, P=0.04), and lymph node metastasis (HR 3.54, P<0.01) were independently associated with survival. After adjustment for the patients’ background characteristics by propensity matching, the 5-year OS rates of the surgery plus chemotherapy group were significantly higher than those of the surgery alone group (78.7% and 32.9%; P < 0.01). The HR for death in the surgery plus chemotherapy group was 0.33 (95% CI 0.15-0.68; p<0.01) in comparison to the surgery alone group.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Surgical resection combined with perioperative chemotherapy was considered to be effective for HGNEC. Sublobar resection might increase the risk of death in HGNEC patients. Therefore if the general condition of the patient permits, perioperative chemotherapy should be performed, and the extent of resection in the treatment of HGNEC should be lobectomy or more.


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