Advanced primary pulmonary lymphoepithelioma-like carcinoma: clinical manifestations, treatment, and outcome

Abstract

Background: Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is rare, with better clinical outcomes than other lung cancers. However, reports on advanced LELC characteristics and prognosis are lacking.

Methods: This retrospective study included adults diagnosed with advanced LELC (at least stage IIIA) between January 2003 and December 2015. Clinical characteristics, treatment modalities, and outcomes were recorded.

Results: Study population comprised 23 patients with a mean age of 63.7±10.6 years. The Eastern Cooperative Oncology Group status on diagnosis was 0 in five patients and 1 in the others. Most patients received multimodality treatment and all received cisplatin-based chemotherapy. Median follow-up duration was 28.8 months. The median progression free survival (PFS) was 14.6 months in patients received palliative chemotherapy. There were nine (39.1%) deaths. The median overall survival (OS) was not achieved. Until July 31, 2016, median OS was 54.1 months for stage IIIB and 27.6 months for stage IV. There was no significant difference in OS among all stages. No prognostic factors were found.

Conclusions: Advanced LELC responded well to cisplatin-based chemotherapy and/or radiotherapy. Main tumor resection is probably beneficial for advanced LELC. Long-term survival is possible for advanced LELC after multimodality treatment.

Keywords: Pulmonary lymphoepithelioma-like carcinoma (LELC); outcome; overall survival (OS).

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1

Waterfall plots for change in tumor burden are shown for patients who had received palliative chemotherapy with cisplatin and docetaxel. The response rate was 83.3% (10 of 12 patients). (The dashed line at 20% represents the boundary for determination of progressive disease, and the dashed line at −30% represents the boundary for determination of partial response.)

Figure 2

The progression free survival of patients who had received palliative chemotherapy. The median PFS was 19.4 months in patients received cisplatin and docetaxel, and 10.7 months in patients received cisplatin and non-docetaxel regimen (P=0.29). PFS, progression free survival.

Figure 3

The overall survival of advanced LELC patients in different stages. The median OS of stage IIIA patients was no reached. The OS was 54.1 months in stage IIIB patients and was 27.6 months in stage IV patients (P=0.38). LELC, lymphoepithelioma-like carcinoma; OS, overall survival.