BACKGROUND: Although chemotherapy and radiation therapy currently are recommended in limited‐stage small cell lung cancer (L‐SCLC), several small series have reported favorable survival outcomes in patients who underwent surgical resection. The authors of this report used a US population‐based database to determine survival outcomes of patients who underwent surgery. METHODS: The Surveillance, Epidemiology, and End Results (SEER) registry was used to identify patients who were diagnosed with L‐SCLC between 1988 and 2002 coded by SEER as localized disease (T1‐T2Nx‐N0) or regional disease (T3‐T4Nx‐N0). Kaplan‐Meier and Cox regression analyses were used to compare overall survival (OS) for all patients. RESULTS: In total, 14,179 patients were identified, including 863 patients who underwent surgical resection. Surgery was associated more commonly with T1/T2 disease (P < .001). Surgery was associated with improved survival for both localized disease and regional disease with improvements in median survival from 15 months to 42 months (P < .001) and from 12 months to 22 months (P < .001), respectively. Lobectomy was associated with the best outcome (P < .001). Patients with localized disease who underwent lobectomy with had a median survival of 65 months and a 5‐year OS rate of 52.6%; whereas patients who had regional disease had a median survival of 25 months and a 5‐year OS rate of 31.8%. On multivariate analysis, the benefit of surgery varied in a time‐dependant fashion. However, the benefit of lobectomy remained across all time intervals (P = .002). CONCLUSIONS: The use of surgery, and particularly lobectomy, in selected patients with L‐SCLC was associated with improved survival outcomes. Future prospective studies should consider the role of surgery as part of the multimodality management of this disease. Cancer 2010. © 2010 American Cancer Society.

Background Small cohort studies have suggested oral tongue squamous cell carcinoma (OTSCC) could be associated with worse prognosis in individuals younger than 40. Methods We compared the survival of all OTSCC cases in the National Cancer Database under 40 years old with those older than 40, excluding patients over 70. Cox regression and propensity score matched (PSM) survival analyses were performed. Results A total of 22 930 OTSCC patients were identified. The under 40 group consisted of 2566 (9.9%) cases; 20664 were 40 to 70 (90.1%). Most were male (13 713, 59.8%), stage I‐II (12 754, 72.4%), and treated by surgery alone (13 973, 63.2%). Survival in patients under 40 was higher (79.6% vs 69.5%, P < .001). In PSM analysis (n = 2928) controlling for all 10 significant factors in multivariate regression, patients under 40 had a 9% higher 5‐year survival (77.1% vs 68.2%, P < .001). Conclusion Contrary to the prior reports, younger patients with OTSCC did not have worse survival in the National Cancer Database.

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