{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T22:43:23Z","timestamp":1777329803731,"version":"3.51.4"},"reference-count":41,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2022,10,25]],"date-time":"2022-10-25T00:00:00Z","timestamp":1666656000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Natural Science Foundation of China","award":["82272673"],"award-info":[{"award-number":["82272673"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Pulmonary large cell carcinoma, a type of non-small cell lung cancer (NSCLC), is a rare neoplasm with poor prognosis. In this study, our aim was to investigate the impact of radiation sequences with surgery for stage III\/IV LCC patients between different age groups, especially in the elderly patients. Patients and Methods: The patients with LCC and other types of NSCLC in the Surveillance, Epidemiology and End Results (SEER) database from 2004 to 2015 were retrospectively analyzed. Then we divided the LCC patients into two age groups: &lt;65 years old group and \u226565 years old group. Propensity score method (PSM) was used to control potential differences between different groups. The overall survival (OS) of LCC patients and other types of NSCLC patients were evaluated by Kaplan\u2013Meier analysis. Univariate and multivariate Cox regression analysis were employed to explore the independent risk factors of OS. The forest plots of HRs for OS were generated to show the above outcomes more visually. Results: In total, 11,349 LCC patients and 129,118 other types of NSCLC patients were enrolled in this study. We divided LCC patients into &lt;65 years old group (4300) and \u226565 years old group (7049). LCC patients was more common in whites (81.4%), males (58.3%), elderly (\u226565 years old: 62.1%), east regions (52.7%), upper lobe (51.6%), right-origin of primary (55.4%), with advanced grade (54.2%) or stage (76.7%). After PSM, Kaplan\u2013Meier analysis and multivariate Cox analysis showed significantly worse survival prognosis for LCC patients compared to other types of NSCLC, especially in the group \u226565 years old (HR: 1.230; 95% CI: 1.171\u20131.291; p &lt; 0.001). For LCC patients, there were some risk survival factors including whites, males, not upper lobe, advanced stage, elder age at diagnosis, bone metastasis, liver metastasis, singled status, no lymphadenectomy, no surgery, and no chemotherapy (p &lt; 0.05). In LCC patients \u226565 years old, radiation after surgery had significantly better impact on overall survival outcomes (HR: 0.863, 95% CI: 0.765\u20130.973, p = 0.016), whereas radiation prior to surgery (HR: 1.425, 95% CI: 1.059\u20131.916, p = 0.019) had significantly worse impact on prognosis of patients. In LCC patients &lt;65 years old, radiation sequences with surgery had no significant impact on the OS of patients (p = 0.580), but \u22654 LNRs had significantly survival benefits to prognosis (HR:0.707, 95% CI: 0.584\u20130.855). Elderly LCC patients had worse malignant tumors than young patients, of which the majority were diagnosed as stage III\/IV tumors. Conclusions: Postoperative radiotherapy may achieve a better prognosis for stage III\/IV LCC patients older than 65 years old compared to other radiation sequences with surgery.<\/jats:p>","DOI":"10.3390\/cancers14215231","type":"journal-article","created":{"date-parts":[[2022,10,25]],"date-time":"2022-10-25T12:29:45Z","timestamp":1666700985000},"page":"5231","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The Clinical Characteristics and Treatments for Large Cell Carcinoma Patients Older than 65 Years Old: A Population-Based Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Anjie","family":"Yao","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Long","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanyu","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"},{"name":"School of Medicine, Tongji University, Shanghai 200092, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yilun","family":"Shen","sequence":"additional","affiliation":[{"name":"Shanghai Songjiang District Jiuting Town Community Healthcare Center, Shanghai 201600, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changhui","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuanshuan","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21708","article-title":"Cancer statistics, 2022","volume":"72","author":"Siegel","year":"2022","journal-title":"CA Cancer J. 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