Clinical Outcomes and Prognosis of Small-Cell Lung Cancer(SCLC) Patients After Surgery: a Single-Centre Retrospective Cohort Study from Peking Union Medical College Hospital

Abstract

Background: Small-cell lung cancer (SCLC) patients are generally not considered to be candidates for surgical intervention. The role of surgery in the multidisciplinary treatment of SCLC remains controversial. The study aims to summarize and analyse the clinical characteristics and prognosis of SCLC patients after surgical treatment and identify the related prognostic factors.Methods: The clinical data of 130 SCLC patients (99 males and 31 females) who were treated by surgery and confirmed by postoperative pathological examination in Peking Union Medical College Hospital from April 2004 to April 2019 were analysed retrospectively.Results: The median age was 60 years (30-83 years), and the median disease duration was 2 months (0.5-48 months). The patients did not have specific clinical or imaging manifestations. Postoperative pathological examination revealed that 36 patients had stage I, 22 patients had stage II, 65 patients had stage III, and seven patients had stage IV SCLC. The median overall survival time was 50 months (95% confidence interval, 10.8-89.2 months). The median survival time of stage I, II, III, and IV SCLC patients were 148 months, 42 months, 32 months, and 10 months, respectively. In patients who underwent surgical treatment, postoperative adjuvant therapy and tumour stage were two significant influencing factors of survival (Cox multivariate analysis P < 0.05).Conclusions: Surgical treatment combined with adjuvant therapy can achieve satisfactory outcomes in selected SCLC patients. Adjuvant therapy and tumour stage are independent risk factors. Surgical treatment is indicated in SCLC patients preoperatively staged as I-IIIa, and anatomical lobectomy and lymphadenectomy combined with postoperative adjuvant therapy are recommended.