Abstract:

Objective: Pulmonary large cell neuroendocrine carcinomas (LNECs) are not common but brain metastases are common in LNEC patients. Because of their rarity, there are no randomized controlled trials on optimal treatment. Generally available data are based on case reports and retrospective studies. For this reason, we retrospectively analyzed patients with LNEC that we followed up for brain metastases to contribute to the literature. Methods: Between 2009 and 2020, 38 patients with brain metastases diagnosed with LNEC in our center were reviewed retrospectively. Results: 38 patients were evaluated. The mean survival time was 5.17 months (95% confidence interval (CI) : 3.17-7.13). In multivariate analysis showed us that shorter overal survival is associated with age (p=0.001), uncontrol of primary cancer (p=0.014), presence of metachronous metastases (p=0.003), poor Eastern Cooperative Oncology Group (ECOG) performance score (p=0.025), and high uric acid level (p=0.001) and high lactate dehydrogenase (LDH) levels (p=0.009). Conclusion: LNECs are rare but aggressive cancers. LNECs often metastasize to the brain. According to our study, high LDH, high uric acid, poor ECOG performance score, ≥65 years, metachronous metastasis, uncontrolled primary tumor are associated poor prognosis. LDH, uric acid, age, presence of metachron metastasis, controbility of primary tumor can be used as easy and inexpensive biomarkers to determine the prognosis and in the follow-up and treatment of patients with LNECs with brain metastases as metastases seen of other cancers.

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