Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Feb 5;27(2):203-210.
doi: 10.3727/096504018X15202953107093. Epub 2018 Mar 9.

Adjuvant Chemotherapy Following Surgical Resection Improves Survival in Patients With Early Stage Small Cell Lung Cancer

Yuanshan Yao  1 , Yinjie Zhou  1 , Zhenhua Yang  1 , Hongbo Huang  1 , Haibo Shen  1
Affiliations

Adjuvant Chemotherapy Following Surgical Resection Improves Survival in Patients With Early Stage Small Cell Lung Cancer

Yuanshan Yao et al. Oncol Res. .

Abstract

The purpose of this study was to determine the effects of resection coupled with standard chemotherapy on the survival prognosis of patients with early stage small cell lung carcinoma (SCLC). Patients (n = 110) with mediastinal lymph node-negative SCLC were enrolled in this study. The baseline clinical data of patients with surgery were retrospectively reviewed. Overall survival (OS) and progression-free survival (PFS) were measured by Kaplan-Meier and log-rank test analyses. Ninety-eight patients received mediastinoscopy biopsy, and pulmonary lobectomy or sublobar resection, and 67 patients underwent adjuvant chemotherapy after pulmonary lobectomy. Adjuvant chemotherapy after surgical intervention was associated with longer OS (median OS: 42.14 vs. 33.53 months, p = 0.01) and PFS (median PFS: 25.20 vs. 13.48 months, p = 0.000) compared to resection alone for all patients. Adjuvant chemotherapy was associated with improvement of survival for N1 patients with stage II (median OS: 36.42 vs. 26.68 months, p = 0.021). The median PFS was 19.02 m (16.08, 21.96) and 13.25 m (10.19, 16.30) (p = 0.031), respectively, for patients of N1 stage who received chemotherapy and those who did not. Cox regression analysis demonstrated that age, TNM stage (N stage, not T stage), and chemotherapy were independent risk factors that might affect overall survival in patients with mediastinal lymph node-negative SCLC. These findings suggest that the application of adjuvant chemotherapy following pulmonary lobectomy is associated with improvements of survival prognoses for patients with SCLC. The combination of surgical intervention with conventional therapy should be taken into consideration as a prospective multidisciplinary regimen for early stage SCLC.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Study design (clinical T1-2N0-1M0 patients).
Figure 2
Figure 2
Overall survival (OS) curves for early stage small cell lung carcinoma (SCLC) patients. (A) OS of all patients, stratified by surgery alone versus surgery in combination with adjuvant chemotherapy (median OS: 42.14 vs. 33.53 months, p = 0.01). (B) OS of cT1–2N0M0 SCLC patients, stratified by surgery alone versus surgery in combination with adjuvant chemotherapy (median OS: 38.74 vs. 32.35 months, p = 0.211). (C) OS of cT1–2N1M0 SCLC patients, stratified by surgery alone versus surgery combination with adjuvant chemotherapy (median OS: 36.42 vs. 26.68 months, p = 0.021).
Figure 3
Figure 3
Progress-free survival (PFS) curves for early stage SCLC patients. (A) PFS of all patients, stratified by surgery alone versus surgery combination with adjuvant chemotherapy (median PFS: 25.20 vs. 13.48 months, p = 0.000). (B) PFS of cT1–2N0M0 SCLC patients, stratified by surgery alone versus surgery in combination with adjuvant chemotherapy (median PFS: 28.05 vs. 15.21 months, p = 0.001). (C) PFS of cT1–2N1M0 SCLC patients, stratified by surgery alone versus surgery combination with adjuvant chemotherapy (median PFS: 19.02 vs. 13.25 months, p = 0.031).
See this image and copyright information in PMC

References

    1. Hong QY, Wu GM, Qian GS, Hu CP, Zhou JY, Chen LA, Li WM, Li SY, Wang K, Wang Q, Zhang XJ, Li J, Gong X, Bai CX, Lung Cancer Group of Chinese Thoracic Society, Chinese Alliance Against Lung Cancer. Prevention and management of lung cancer in China. Cancer 2015;121(Suppl 17):3080–8. - PubMed
    1. Kalemkerian GP, Akerley W, Bogner P, Borghaei H, Chow LQ, Downey RJ, Gandhi L, Ganti AK, Govindan R, Grecula JC, Hayman J, Heist RS, Horn L, Jahan T, Koczywas M, Loo BW Jr, Merritt RE, Moran CA, Niell HB, O’Malley J, Patel JD, Ready N, Rudin CM, Williams CC Jr, Gregory K, Hughes M, National Comprehensive Cancer Network. Small cell lung cancer. J Natl Compr Canc Netw. 2013;11(1):78–98. - PMC - PubMed
    1. Hou SZ, Cheng ZM, Wu YB, Sun Y, Liu B, Yuan MX, Wang XD. Evaluation of short-term and long-term efficacy of surgical and non-surgical treatment in patients with early-stage small cell lung cancer: A comparative study. Cancer Biomark. 2017;19(3):249–56. - PubMed
    1. Jones CD, Cummings IG, Shipolini AR, McCormack DJ. Does surgery improve prognosis in patients with small-cell lung carcinoma? Interact Cardiovasc Thorac Surg. 2013;16(3):375–80. - PMC - PubMed
    1. Kim ES. Chemotherapy resistance in lung cancer. Adv Exp Med Biol. 2016;893:189–209. - PubMed

LinkOut - more resources