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. 2021 Jul;12(13):1943-1951.
doi: 10.1111/1759-7714.13977. Epub 2021 May 9.

Survival and pretreatment prognostic factors for extensive-stage small cell lung cancer: A comprehensive analysis of 358 patients

Li-Ling Huang  1 , Xing-Sheng Hu  1 , Yan Wang  1 , Jun-Ling Li  1 , Hong-Yu Wang  1 , Peng Liu  1 , Jian-Ping Xu  1 , Xiao-Hui He  1 , Xue-Zhi Hao  1 , Pei-Di Jiang  2 , Yu-Tao Liu  1 , Jian Luo  1 , Sheng-Yu Zhou  1 , Jin-Wan Wang  1 , Jian-Liang Yang  1 , Yan Qin  1 , Peng Yuan  2 , Lin Lin  1 , Yuan-Kai Shi  1
Affiliations

Survival and pretreatment prognostic factors for extensive-stage small cell lung cancer: A comprehensive analysis of 358 patients

Li-Ling Huang et al. Thorac Cancer. 2021 Jul.

Abstract

Background: Extensive-stage small cell lung cancer (ES-SCLC) is deemed as a fatal malignancy with a poor prognosis. Although immunotherapy has gradually played an important role in the treatment of ES-SCLC since 2018, ES-SCLC treatment data and patient outcome before 2018, when chemotherapy served as a fundamental therapeutic strategy, is still meaningful as a summary of the situation regarding previous medical treatment and is a baseline for comparative data. In addition, the prognostic factors of ES-SCLC have failed to reach a consensus until now. Therefore, this study aimed to evaluate survival and identify the prognostic factors in an ES-SCLC population.

Methods: We retrospectively collected the detailed medical records of 358 patients with ES-SCLC from January 1, 2011 to December 31, 2018 in a Chinese top-level cancer hospital. The prognostic factors were evaluated by Cox univariate and multivariate analysis.

Results: The median overall survival (OS) of ES-SCLC patients (N = 358) was 14.0 months, the one- and two-year OS rates were 56.2% and 21.7%, respectively. Moreover, we identified two demographic characters (age ≥ 70, smoking index ≥ 400), one tumor burden factor (bone multimetastasis), two tumor biomarkers (cyfra211, CA125) and two laboratory indexes (decreased Na, PLR < 76) as independent prognostic factors for OS in this patient population. Progression-free survival (PFS) data of 238 patients was obtained for further analysis, and the median PFS was 6.2 months, and six-month and one-year PFS rates were 51.7% and 14.3%, respectively. Elevated cyfra211, decreased Hb and Na were identified as independent prognostic factors for PFS.

Conclusions: This study provides real-world evidence of the survival and prognosis of ES-SCLC patients which will enable better evaluation and clinical decision-making in the future.

Keywords: extensive-stage; prognosis; small cell lung cancer; survival.

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Conflict of interest statement

All authors approved the final manuscript and no conflict of interest is reported.

Figures

FIGURE 1
FIGURE 1
Overall survival (a) and progression‐free survival (b)
See this image and copyright information in PMC

References

    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram MD, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021. 10.3322/caac.21660. - DOI - PubMed
    1. Shepherd FA, Ginsberg RJ, Haddad R, Feld R, Sagman U, Evans WK, et al. Importance of clinical staging in limited small‐cell lung cancer: a valuable system to separate prognostic subgroups. The University of Toronto Lung Oncology Group. J Clin Oncol. 1993;11(8):1592–7. - PubMed
    1. Fiegl M, Pircher A, Waldthaler C, Gamerith G, Kocher F, Pall G, et al. Small steps of improvement in small‐cell lung cancer (SCLC) within two decades: a comprehensive analysis of 484 patients. Lung Cancer. 2014;84(2):168–74. - PubMed
    1. Fukui T, Itabashi M, Ishihara M, Hiyoshi Y, Kasajima M, Igawa S, et al. Prognostic factors affecting the risk of thoracic progression in extensive‐stage small cell lung cancer. BMC Cancer. 2016;16:197. - PMC - PubMed
    1. Stinchcombe TE, Fan W, Schild SE, Vokes EE, Bogart J, Le QT, et al. A pooled analysis of individual patient data from National Clinical Trials Network clinical trials of concurrent chemoradiotherapy for limited‐stage small cell lung cancer in elderly patients versus younger patients. Cancer. 2019;125(3):382–90. - PMC - PubMed

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