&lt;p&gt;Comparison Of Long Term Results Between Matched Chemoradiotherapy And Surgery For Limited Stage Small Cell Lung Cancer&lt;/p&gt;

Chen, Meng Yuan; Hu, Xiao; Bao, Yongzhan; Wang, Jin; Chen, Ya‐Mei; Xu, Yu; Jin, Jiyuan; Chen, Ming

doi:10.2147/cmar.s222882

Cited by 9 publications

(19 citation statements)

References 18 publications

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“…Analyses of stage IIIA SCLC cases in the SEER database also demonstrated that surgery enhanced survival over chemoradiation [ 12 , 14 ]. However, the clinical benefit of surgery remains controversial; a retrospective study comparing the outcomes of SCLC patients following surgery and chemoradiation found similar survival rates for patients with stage IIIA disease [ 30 ]. Our analyses focused on N2 disease; in these patients, surgery achieved longer OS than radiation and chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Effect of surgery on survival in patients with stage III N2 small cell lung cancer: propensity score matching analysis and nomogram development and validation

Chai

Feng

et al. 2021

World J Surg Onc

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Background The standard treatment of stage III N2 small cell lung cancer (SCLC) is concurrent chemoradiation, and surgery is not recommended. This study was aimed to evaluate whether surgery has survival benefits in patients with stage III N2 SCLC and investigate the factors influencing survival of surgery. Methods Patients diagnosed with stage T1-4N2M0 SCLC from 2004 to 2015 were selected from the Surveillance Epidemiology End Results database. Propensity score matching (PSM) was used to balance confounders between patients who underwent surgery and those treated with radiation and/or chemotherapy. We compared overall survival (OS) of the two groups using Kaplan-Meier curves and a Cox proportional hazard model. We also identified prognostic factors in patients with surgical resection, and a nomogram was developed and validated for predicting postoperative OS. Results −A total of 5576 patients were included in the analysis; of these, 211 patients underwent surgery. PSM balanced the differences between the two groups. The median OS was longer in the surgery group than in the non-surgery group (20 vs. 15 months; p = 0.0024). Surgery was an independent prognostic factor for longer OS in the multivariate Cox regression analysis, and subgroup analysis revealed a higher survival rate in T1 stage patients treated with surgery (hazard ratio = 0.565, 95% confidence interval: 0.401–0.798; p = 0.001). In patients who underwent surgery, four prognostic factors, including age, T stage, number of positive lymph nodes, and radiation, were selected into nomogram development for predicting postoperative OS. C-index, decision curve analyses, integrated discrimination improvement, and time-dependent receiver operating characteristics showed better performance in nomogram than in the tumor-node-metastasis staging system. Calibration plots demonstrated good consistency between nomogram predicted survival and actual observed survival. The patients were stratified into three different risk groups by prognostic scores and Kaplan-Meier curves showed significant difference between these groups. Conclusions These results indicate that surgery can prolong survival in patients with operable stage III N2 SCLC, particularly those with T1 disease. A nomogram that includes age, T stage, number of positive lymph nodes, and radiation can be used to predict their long-term postoperative survival.

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Section: Discussionmentioning

confidence: 99%

Effect of surgery on survival in patients with stage III N2 small cell lung cancer: propensity score matching analysis and nomogram development and validation

Chai

Feng

et al. 2021

World J Surg Onc

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“…Most studies identified enrolled patients with limited-stage SCLC from single centers with n < 500 patients. [ 21 , 22 , 26 , 29 – 32 , 37 , 40 , 41 , 55 , 56 ] Of these, nearly all examined patients in Asia, including 6 in China, [ 21 , 26 , 30 , 32 , 37 , 40 ] 1 in Japan, [ 29 ] and 2 from South Korea. [ 22 , 41 ]…”

Section: Resultsmentioning

confidence: 99%

“…[ 38 ] Surgery with CT/CRT conferred a significant survival advantage compared with CT/CRT alone (median OS: 18–79 vs 12–23 months, P < .05, all), [ 29 , 39 , 40 , 56 ] and relative to palliative CT or RT (40.2 vs 10.7 months, P < .001) [ 56 ] in stage I to III SCLC. Surgery did not result in a significant survival advantage in patients with stage II to III SCLC [ 32 ] or in subgroups with stage IIIB or IIIC. [ 36 ]…”

Section: Resultsmentioning

confidence: 99%

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A systematic literature review of real-world treatment outcomes of small cell lung cancer

et al. 2022

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Background: Robust evidence from real-world studies is needed to aid decision-makers and other stakeholders in choosing the best treatment options for patients. The objective of this work was to assess real-world outcomes of treatment strategies for limited-and extensive-stage small cell lung cancer (SCLC) prior to the global introduction of immunotherapies for this disease.Methods: Searches were conducted in MEDLINE and Embase to identify articles published in English from October 1, 2015, through May 20, 2020. Searches were designed using a combination of Medical Subject Heading (Medline), Emtree (Embase subject headings), and free-text terms such as SCLC. Observational studies reporting data on outcomes of initial treatment strategies in patients with limited-and extensive-stage SCLC were included. Studies with limited sample sizes (<100 patients), enrolled all patients prior to 2010, or did not report outcomes for limited-and extensive-stage SCLC separately were excluded. Data were extracted into a predesigned template by a single researcher. All extractions were validated by a second researcher, with disagreements resolved via consensus.Results: Forty articles were included in this review. Most enrolled patients from the United States (n = 18 articles) or China (n = 12 articles). Most examined limited-stage (n = 27 articles) SCLC. All studies examined overall survival as the primary outcome. Articles investigating limited-stage SCLC reported outcomes for surgery, chemotherapy and/or radiotherapy, and adjuvant prophylactic cranial irradiation. In studies examining multiple treatment strategies, chemoradiotherapy was the most commonly utilized therapy (56%-82%), with chemotherapy used in 18% to 44% of patients. Across studies, median overall survival was generally higher for chemoradiotherapy (15-45 months) compared with chemotherapy alone (6.0-15.6 months). Studies of extensive-stage SCLC primarily reported on chemotherapy alone, consolidative thoracic radiotherapy, and radiotherapy for patients presenting with brain metastases. Overall survival was generally lower for patients receiving chemotherapy alone (median: 6.4-16.5 months; 3 years, 5%-14.9%) compared with chemotherapy in combination with consolidative thoracic radiotherapy (median: 12.1-18.0 months; 3 years, 15.0%-18.1%). Studies examining whole-brain radiotherapy for brain metastases reported lower median overall survival (5.6-8.7 months) compared with stereotactic radiosurgery (10.0-14.5 months).Conclusions: Under current standard of care, which has remained relatively unchanged over the past few decades, prognosis remains poor for patients with SCLC.

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“…Zhang et al retrospectively reviewed patients with combined SCLC who had undergone surgery in 2 institutions and concluded that adjuvant therapy was associated with significantly improved survival in complete resection and lymphadenectomy patients (12). Other research groups have similarly reported the benefits of surgery in limitedstage SCLC patients (13,14). These latter 2 studies reported the clinical benefits of surgery and adjuvant chemotherapy in limited stage SCLC, but due to the low number of patients with stage I/II SCLC in these studies, which are based on Asian populations, it was mostly patients with stage I-IIIA of the disease who were enrolled.…”

Section: Introductionmentioning

confidence: 99%

Using T stage and tumor thrombosis as predictive factors for patients with resected I–IIA small cell lung cancer: a retrospective study

Mao¹,

Ni²,

Niu³

et al. 2021

Transl Cancer Res TCR

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Background: Surgery is recognized as an important part of treating stage I-IIA small cell lung cancer (SCLC), but few studies have explored the predictive factors for overall survival (OS) or time to tumor progression (TTP). This paper aims to explore the predictive factors related to improved overall and relapse-free survival. Methods: Patients with stage I-IIA SCLC were reviewed between January 1st, 2014, and December 30th, 2016, at the Shanghai Chest Hospital. Basic patient characteristics and clinical data were collected, including age, sex, tumor (T) stage, pathological characteristics, and treatment. Patient follow-ups were conducted by checking medical records or phoning the patient, with survival data and instances of recurrence and/ or metastasis being collected and recorded. Univariate and multivariate analyses were used to identify the predictive factors.Results: A total of 59 patients were enrolled in this study, and the median follow-up duration was 53.7 months. The 3-year disease free and 3-year OS rates were 62.5% and 75.0%, respectively. The 5-year disease free and 5-year OS rates were not reached. Univariate and multivariate analyses revealed that a higher T stage [hazard ratio (HR) 3.210, P=0.048], the presence of tumor thrombosis (HR 6.021, P=0.043), and the absence of adjuvant chemotherapy (HR 3.425, P=0.059) were more reflective of shorter TTP than other factors, with the presence of adjuvant chemotherapy also correlating with improved OS. Conclusions:A patient having a T1 stage with no tumor thrombus and receiving adjuvant chemotherapy were observed as positive factors for longer periods of TTP, and adjuvant chemotherapy was a favorable predictor for the OS of patients with resected stage I-IIA SCLC.

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<p>Comparison Of Long Term Results Between Matched Chemoradiotherapy And Surgery For Limited Stage Small Cell Lung Cancer</p>

Cited by 9 publications

References 18 publications

Effect of surgery on survival in patients with stage III N2 small cell lung cancer: propensity score matching analysis and nomogram development and validation

Effect of surgery on survival in patients with stage III N2 small cell lung cancer: propensity score matching analysis and nomogram development and validation

A systematic literature review of real-world treatment outcomes of small cell lung cancer

Using T stage and tumor thrombosis as predictive factors for patients with resected I–IIA small cell lung cancer: a retrospective study

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