Sugimoto A, Umemura S, Miyoshi T, et al. - Among 81 patients suffering from high-grade neuroendocrine carcinomas (HGNEC) [SCLC (small cell lung cancer), n = 42; LCNEC (large cell neuroendocrine carcinoma), n = 39] who had complete resection, this investigation was performed to unveil the prognostic value of tumor necrosis. Digital image analysis was conducted to quantify the proportion of necrosis in the tumor tissues. The median proportion of necrosis was 10.6 % (range, 0–62.8 %). Patients with 10 % or higher necrosis (necrosis ≥ 10 %) were found to have significantly higher cumulative incidence of recurrence and lung cancer-specific cumulative incidence of death, vs in those with less than 10 % (necrosis < 10 %). Overall, findings showed a negative prognostic value of high proportion of tumor necrosis (≥ 10 %) in surgically resected HGNEC.