Clinical characteristics and treatments of large cell lung carcinoma: a retrospective study using SEER data

BACKGROUND: Large cell lung carcinoma (LCLC) is a rare malignancy with poor outcome, and little is known about its clinical characteristics and treatments. METHODS: The clinical information of LCLC patients was collected from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. The Kaplan-Meier method was used to determine the overall survival (OS) and lung cancer-specific survival (LCSS). Univariate and multivariate analyses were further performed to investigate the independent prognostic factors of OS. A final nomogram was built using the Cox proportional hazards model. RESULTS: In total, 4,099 patients diagnosed with LCLC were included. 70.2% of patients were older than 60, and more male patients were found. Besides, 60.2% of lesions were found in the upper lobe. Moreover, most patients showed poor differentiation and presented with stage III or IV. Multivariate Cox analysis revealed age, gender, marital status, laterality, tumor size, stage, chemotherapy and surgery were independent prognostic factors of LCLC. The prognosis after surgery combined with chemotherapy was better than that after surgery alone (P=0.041, HR =0.875, 95% CI: 0.771–0.993). The nomogram had good discrimination with a concordance index of 0.757. CONCLUSIONS: LCLC is more common in the elderly and males. Most of lesions are located in the upper lobe and are diagnosed at stage III/IV with poor differentiation. Age, gender, marital status, laterality, tumor size, stage, chemotherapy and surgery were associated with OS. Surgery combined with chemotherapy may achieve a better prognosis and the nomogram accurately predicted the 1-, 3-, and 5-year OS.