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. 2018 Apr 6;9(8):1421-1429.
doi: 10.7150/jca.23583. eCollection 2018.

Survival Outcomes for Patients with Surgical and Non-Surgical Treatments in Stages I-III Small-Cell Lung Cancer

Keying Che  1 , Hongchang Shen  2 , Xiao Qu  1 , Zhaofei Pang  1 , Yuanzhu Jiang  3 , Shaorui Liu  1 , Xudong Yang  1 , Jiajun Du  1   3
Affiliations

Survival Outcomes for Patients with Surgical and Non-Surgical Treatments in Stages I-III Small-Cell Lung Cancer

Keying Che et al. J Cancer. .

Abstract

Objectives: Chemotherapy and radiation therapy are the standard treatments for patients with small-cell lung cancer (SCLC). However, recent studies suggest that patients with limited stage (I-III) SCLC may benefit from surgical treatment. This study was performed to evaluate the survival outcomes of surgery for stage I-III SCLC. Methods: This analysis used data from the Surveillance, Epidemiology, and End Results (SEER) database. All stage I-III (excluding N3 and Nx) SCLC patients received a diagnosis between 2004 and 2014. Overall survival (OS) and lung cancer-specific survival (LCSS) were determined by Kaplan-Meier analysis and compared using the log-rank test. A Cox proportional hazard model identified relevant survival variables. Results: A total of 4,780 histologically confirmed patients were identified from the SEER database, comprising 1,018 patients (21.3%) with stage I disease; 295 (6.2%) with stage II; and 3,467 (72.5%) with stage III disease. Among all of the patients, 520 had been treated with surgery, the majority (n = 344; 66.2%) of whom had stage I disease. The hazard ratio (HR) for OS and LCSS, in patients who underwent surgery, according to stage were as follows: OS, 0.369 and LCSS, 0.335 in stage I; OS, 0.549 and LCSS, 0.506 in stage II; and OS, 0.477 and LCSS, 0.456 in stage III (all p < 0.001). Patients who underwent surgery had significantly better OS, and lobectomy was associated with the best outcome. Conclusions: Surgical resection was associated with significantly improved OS outcomes and should be considered in the management of stage I-III SCLC.

Keywords: SEER; Small-cell lung cancer; lobectomy; postoperative radiation therapy; surgical resection.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Fig 1
Fig 1
Kaplan-Meier survival analysis for OS and LCSS based on surgery or no-surgery at stage I-III and each stage of SCLC.
Fig 1
Fig 1
Kaplan-Meier survival analysis for OS and LCSS based on surgery or no-surgery at stage I-III and each stage of SCLC.
Fig 2
Fig 2
Kaplan-Meier survival analysis for OS and LCSS based on surgery type.
Fig 3
Fig 3
Kaplan-Meier survival analysis for OS and LCSS to assess the impact of surgery alone or PORT for stage I-III SCLC.
See this image and copyright information in PMC

References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA: a cancer journal for clinicians. 2016;66:7–30. - PubMed
    1. Torre LA, Siegel RL, Jemal A. Lung Cancer Statistics. Advances in experimental medicine and biology. 2016;893:1–19. - PubMed
    1. Conen K, Hagmann R, Hess V, Zippelius A, Rothschild SI. Incidence and predictors of Bone Metastases (BM) and Skeletal-Related Events (SREs) in Small Cell Lung Cancer (SCLC): A Swiss patient cohort. Journal of Cancer. 2016;7:2110–6. - PMC - PubMed
    1. Mountain CF. The international system for staging lung cancer. Seminars in surgical oncology. 2000;18:106–15. - PubMed
    1. Ganti AK, Zhen W, Kessinger A. Limited-stage small-cell lung cancer: therapeutic options. Oncology (Williston Park, NY) 2007;21:303–12. discussion 12, 15-8, 23. - PubMed

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