Long-term survival in small-cell carcinoma of the lung: a population experience.

Abstract

Small-cell lung carcinoma (SCLC) is a rapidly progressive and fatal disease. Historically, surgical resection or radiotherapy of the primary tumor has done little to prolong survival, although the use of combination chemotherapy is more effective. Reported here is the survival experience of 1,538 incident cases of SCLC identified through the Surveillance, Epidemiology and End Results Program in western Washington State from 1974 to 1982. The survival experience of this population series is similar to that reported from specialized referral centers. For 71 of 78 persons surviving at least 24 months, the original diagnostic slides were independently reviewed, 47 cases being confirmed as SCLC. No differences were found in actuarial survival estimates between those confirmed and those not confirmed as SCLC. Multivariate survival analysis was conducted to estimate the effects on survival of stage, therapy, age, sex, primary site, and histologic type. All factors except primary site and histologic type significantly influence initial survival rates. However, the only factor related to post--two-year (ie, long-term) survival, once stage is accounted for, is whether surgery was received as a first course of therapy. Those not receiving surgery were at four times the risk of death as those who did. These results indicate that long-term survival can be achieved in patients with SCLC treated in the community, and that the chance of surviving an additional two years for such patients is approximately 40%.

Time trends in the outcome of lung cancer management: a study of 9,090 cases diagnosed in the Mersey Region, 1974-86

“…This paper presents the results of a large population based study in a Health Region of the UK, and has demonstrated the impact of changes in treatment policies, which are not brought out in reports of single or multicentre trials, on account of their selection criteria, relatively small numbers and referral bias (Davis et al, 1985;Carter, 1985).…”

Progress in the management and outcome of small-cell lung cancer in a French region from 1981 to 1994

“…In most North American series, prognosis is significantly more favourable among women (Davis et al, 1985;Johnson et al, 1988;Spiegelman et al, 1989;Wolf et al, 1991;Chute et al, 1997). Neither in our study nor in a French series of 1280 patients included in four consecutive trials did sex appear as a significant independent factor.…”

Survival in small cell lung cancer in India: Prognostic utility of clinical features, laboratory parameters and response to treatment

“…[1,2] The aggressive nature of this variant is evidenced by the fact that the overall 2-year survival rate is 5.9% and the 5-year survival rate, a dismal 2.4%. [3,4] These figures have not changed significantly over the past few decades, in spite of several advances in chemotherapy and radiotherapy. [5] The early identification of simple prognostic factors in such a tumor is important, as it would assist in defining sub-groups for which different treatment modalities could be targeted, for example, a sub-group of patients having no reasonable chance of long term survival could be considered for short-term chemotherapy associated with minimal toxicity or offered palliative care only, whereas patients with better chance of long term survival could be treated more aggressively with curative treatment.…”