Global QoL 4.65 (1.14-8.16) d Functional domain a Physical 2.02 ( -1.01-5.05) Role 2.09 (-1.87-6.04) Emotional 2.58 (-0.06-5.22) Cognitive -3.18 (-6.47-0.12) Social 2.27 (-1.30-5.85) Symptom scale/item b Fatigue -5.67 (-9.42--1.92) d Nausea and Vomiting -7.86 (-9.86--5.86) c Pain 1.16 (-2.49-4.82) Dyspnea 1.72 (-1.98-5.43) Insomnia -7.95 (-11.25--4.64) c Appetite Loss -9.21 (-11.80--6.62) c Constipation -4.93 (-9.07--0.79) e Diarrhea -12.03 (-15.49--8.58) c Financial Difficulties -1.04 (-4.90-2.82

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serum level of SCC (p<0.001), pR0 resection (p¼0.02), adjuvant chemotherapy (p<0.001), and histological pure SCLC (p¼0.002). In preoperative factor, multivariate Cox proportional hazard model analysis revealed that overall survival was shorter in patients with increased SCC levels and cN1or 2. Conclusion: We conclude that pulmonary resection for early-stage SCLC is a safe and effective treatment strategy, and adjuvant chemotherapy may be useful in patients undergoing surgery in a practical management. Increased SCC levels and cN1 or 2 were identified as prognosis-related criteria for a poor prognosis of resected early SCLC.

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