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

Yao, Yuanshan; Zhou, Ye; Yang, Zhenhua; Huang, Haifang; Shen, Haibo

doi:10.3727/096504018x15202953107093

Cited by 10 publications

(10 citation statements)

References 25 publications

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“…Through univariate and multivariate analysis, age, sex, surgery, T stage, LND, LNM, and chemotherapy were recognized as independent prognostic parameters, which was in high accordance with previous reports. 11,16,[21][22][23] Notably, radiotherapy was revealed not to be a significant prognostic factor in our study, which may be attributed to the contradictory impact of radiotherapy on patients with different N statuses. Wong et al 12 reported that radiotherapy deteriorated OS in N0 SCLC patients, but improved survival in N2-stage patients.…”

Section: Discussioncontrasting

confidence: 61%

Development and Validation of a Nomogram Prognostic Model for Resected Limited-Stage Small Cell Lung Cancer Patients

Zeng

Tan

et al. 2021

Ann Surg Oncol

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Background In this study, we developed and validated nomograms for predicting the survival in surgically resected limited-stage small cell lung cancer (SCLC) patients. Methods The SCLC patients extracted from the Surveillance, Epidemiology, and End Results database between 2000 and 2014 were reviewed. Significant prognostic factors were identified and integrated to develop the nomogram using multivariable Cox regression. The model was then validated internally by bootstrap resampling, and externally using an independent SCLC cohort diagnosed between 2000 and 2015 at our institution. The prognostic performance was measured by the concordance index (C-index) and calibration curve. Results A total of 1006 resected limited-stage SCLC patients were included in the training cohort. Overall, 444 cases from our institution constituted the validation cohort. Seven prognostic factors were identified and entered into the nomogram construction. The C-indexes of this model in the training cohort were 0.723, 0.722, and 0.746 for predicting 1-, 3-, and 5-year overall survival (OS), respectively, and 0.816, 0.710, and 0.693, respectively, in the validation cohort. The calibration curve showed optimal agreement between nomogram-predicted survival and actual observed survival. Additionally, significant distinctions in survival curves between different risk groups stratified by prognostic scores were also observed. The proposed nomogram was then deployed into a website server for convenient application. Conclusions We developed and validated novel nomograms for individual prediction of survival for resected limited-stage SCLC patients. These models perform better than the previously widely used staging system and may offer clinicians instructions for strategy making and the design of clinical trials.

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Section: Discussioncontrasting

confidence: 61%

Development and Validation of a Nomogram Prognostic Model for Resected Limited-Stage Small Cell Lung Cancer Patients

Zeng

Tan

et al. 2021

Ann Surg Oncol

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“…Furthermore, reports show that chemotherapy/ radiotherapy may be effective and could decrease the risk of recurrence in SCLC, and could provide a survival benefit to patients 26,27 . However, chemotherapy/radiotherapy alone is associated with poor prognosis when compared with surgery with adjuvant therapy for early stage SCLC 28,29 . These results support an increased role of surgery in the multimodality treatment of SCLC, and the combination of surgery with chemotherapy/ radiotherapy could be beneficial in patients with early stage SCLC.…”

Section: Discussionmentioning

confidence: 99%

Benefits of surgery in the multimodality treatment of stage IIB-IIIC small cell lung cancer

Yang¹,

Yuan²,

Zhan³

et al. 2019

J. Cancer

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Surgery combined with chemotherapy/radiotherapy is recommended for early stage small cell lung cancer (SCLC); however, the role of surgery in the multimodality treatment of advanced disease remains controversial. The clinical data of patients between 2000 and 2015 were obtained from the Surveillance, Epidemiology, and End Results database. The surgery group included 998 patients with stage IIB-IIIC. A matched non-surgery group (n = 2994) was generated by propensity score matching. The Kaplan-Meier method and log-rank tests were used for survival analyses. Univariate and multivariate analyses were used to identify significant prognostic factors. After matching, there were no significant differences between the two groups in race, age, sex, T classification, N classification, TNM stage, marital status, primary sites, and origin record NAACCR Hispanic Identification Algorithm (NHIA). The surgery group showed better overall survival and cancer-specific survival than the non-surgery group. Univariate and multivariate analyses showed that therapy methods, age, sex, T classification, and N classification were independent prognostic predictors for stage IIB-IIIC SCLC (all P < 0.05). Stratified analyses showed that survival outcomes favored surgery in any age groups, men and women, any T classification except T3, and N0-2 but not N3 compared with non-surgical treatment. The survival differences favored surgery in stage IIB and IIIA SCLC, although they were not significant in stage IIB and IIIC SCLC. Therefore, surgery was associated with improved survival in stage IIB and IIIA SCLC, but not in stage IIIB and IIIC SCLC.

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“…Patients with PNENs have tumors sufficiently localized to be considered treatable by surgical resection, and among those whose tumors are successfully resected, approximately 90-98% of patients with typical carcinoid, and 50-60% of atypical carcinoid, survive 5 years ( 2 , 3 ) even developing local invasiveness, dissemination to regional lymph nodes, and distant metastasis ( 4 , 5 ) which occur in 3% of typical carcinoids and 21% for atypical carcinoids ( 6 – 8 ). In contrast, only 20-30% of the patients with large cell neuroendocrine carcinoma survive 5 years after surgical resection and adjuvant chemotherapy ( 9 ), and only 10% of the patients with small cell lung carcinoma survive 5 years after Cisplatin + Carboplatin + Etoposide ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Neuroendocrine Neoplasms Overexpressing Epithelial-Mesenchymal Transition Mechanical Barriers Genes Lack Immune-Suppressive Response and Present an Increased Risk of Metastasis

et al. 2021

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Typical carcinoids (TC), atypical carcinoids (AC), large cell neuroendocrine carcinomas (LCNEC), and small cell lung carcinomas (SCLC) encompass a bimodal spectrum of metastatic tumors with morphological, histological and histogenesis differences, The hierarchical structure reveals high cohesiveness between neoplastic cells by mechanical desmosomes barrier assembly in carcinoid tumors and LCNEC, while SCLC does not present an organoid arrangement in morphology, the neoplastic cells are less cohesive. However, the molecular mechanisms that lead to PNENs metastasis remain largely unknown and require further study. In this work, epithelial to mesenchymal transition (EMT) transcription factors were evaluated using a set of twenty-four patients with surgically resected PNENs, including carcinomas. Twelve EMT transcription factors (BMP1, BMP7, CALD1, CDH1, COL3A1, COL5A2, EGFR, ERBB3, PLEK2, SNAI2, STEAP1, and TCF4) proved to be highly expressed among carcinomas and downregulated in carcinoid tumors, whereas upregulation of BMP1, CDH2, KRT14 and downregulation of CAV2, DSC2, IL1RN occurred in both histological subtypes. These EMT transcription factors identified were involved in proliferative signals, epithelium desmosomes assembly, and cell motility sequential steps that support PNENs invasion and metastasis in localized surgically resected primary tumor. We used a two-stage design where we first examined the candidate EMT transcription factors using a whole-genome screen, and subsequently, confirmed EMT-like changes by transmission electron microscopy and then, the EMT-related genes that were differentially expressed among PNENs subtypes were predicted through a Metascape analysis by in silico approach. A high expression of these EMT transcription factors was significantly associated with lymph node and distant metastasis. The sequential steps for invasion and metastasis were completed by an inverse association between functional barrier created by PD-L1 immunosuppressive molecule and EMT transcriptional factors. Our study implicates upregulation of EMT transcription factors to high proliferation rates, mechanical molecular barriers disassembly and increased cancer cell motility, as a critical molecular event leading to metastasis risk in PNENs thus emerging as a promising tool to select and customize therapy.

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

Cited by 10 publications

References 25 publications

Development and Validation of a Nomogram Prognostic Model for Resected Limited-Stage Small Cell Lung Cancer Patients

Development and Validation of a Nomogram Prognostic Model for Resected Limited-Stage Small Cell Lung Cancer Patients

Benefits of surgery in the multimodality treatment of stage IIB-IIIC small cell lung cancer

Pulmonary Neuroendocrine Neoplasms Overexpressing Epithelial-Mesenchymal Transition Mechanical Barriers Genes Lack Immune-Suppressive Response and Present an Increased Risk of Metastasis

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