Treatment outcomes of primary pulmonary lymphoepithelioma-like carcinoma: A series of 22 patients and treatment strategy review

Abstract

Objectives: Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare subgroup of non-small-cell lung cancer. Limited published series suggested that it might be associated with more favourable survival than ordinary non-small-cell lung cancer. We set out to review the treatment outcomes of patients with primary pulmonary LELC treated in our institution since 1994. Methods: All patients with pathologically confirmed primary pulmonary LELC treated between 1994 and 2012 were retrospectively reviewed. Treatment modalities and outcomes- including local control rate, disease-free and overall survival- were analysed. Results: Twenty-two patients with primary pulmonary LELC were identified. Their median follow-up duration was 33 months (range, 1 day to 106 months). Surgery was the mainstay of treatment for patients with stage I to II diseases. Those with advanced non-metastatic disease (n = 5) treated with high-dose radiotherapy (EQD2 60 Gy) with or without platinum-based chemotherapy had a local control rate of 100% after a median follow-up of 68 months. The 5-year progression-free survival (PFS) and overall survival (OS) were 53% and 80%, respectively. Their median PFS and OS had not reached at the time of publication. For patients with stages III and IV disease beyond radical radiotherapy portals, palliative platinum doublets gave a median disease-free survival of 10 months in 12 patients. The 5-year OS of stage /-//, III, and IV patients were 41%, 38%, and 25%, respectively (p = 0.61). Their median OS durations were 58, 30, and 19 months, respectively. Conclusion: Our series echoed prior suggestions that primary pulmonary LELC achieves favourable outcomes. © 2013 Hong Kong College of Radiologists.