Epidemiology, treatment, and survival in small cell lung cancer in Spain: Data from the Thoracic Tumor Registry

Abstract

Background Small-cell lung cancer (SCLC) is an aggressive disease with high metastatic potential and poor prognosis. Due to its low prevalence, epidemiological and clinical information of SCLC patients retrieved from lung cancer registries is scarce. Patients and methods This was an observational multicenter study that enrolled patients with lung cancer and thoracic tumors, recruited from August 2016 to January 2020 at 50 Spanish hospitals. Demographic and clinical data, treatment patterns and survival of SCLC patients included in the Thoracic Tumor Registry (TTR) were analyzed. Results With a total of 956 cases, the age of 64.7 ± 9.1 years, 78.6% were men, 60.6% smokers, and ECOG PS 0, 1 or ≥ 2 in 23.1%, 53.0% and 23.8% of cases, respectively. Twenty percent of patients had brain metastases at the diagnosis. First-line chemotherapy (CT), mainly carboplatin or cisplatin plus etoposide was administered to >90% of patients. In total, 36.0% and 13.8% of patients received a second and third line of CT, respectively. Median overall survival was 9.5 months (95% CI 8.8–10.2 months), with an estimated rate of 70.3% (95% CI 67.2–73.4%), 38.9% (95% CI 35.4–42.4%), and 14.8% (95% CI 11.8–17.8%) at 6, 12 and 24 months respectively. Median progression-free survival was 6.3 months. Higher mortality and progression rates were significantly associated with male sex, older age, smoking habit, and ECOG PS 1–2. Long-term survival (> 2 years) was confirmed in 6.6% of patients, showing a positive correlation with better ECOG PS, poor smoking and absence of certain metastases at diagnosis. Conclusion This study provides an updated overview of the clinical situation and treatment landscape of ES-SCLC in Spain. Our results might assist oncologists to improve current clinical practice towards a better prognosis for these patients.

SEOM-GECP Clinical guidelines for diagnosis, treatment and follow-up of small-cell lung cancer (SCLC) (2022)

“…Some reported prognostic factors include performance status (PS), increased age, male gender, and numerous metastatic sites at baseline [ 4 ]. But certainly, prognosis is largely related to the stage of the disease and therapeutic approach: whereas LS disease is potentially curable, with 20–30% of patients alive at 5 years and median overall survival (mOS) ranging between 25 and 30 months [ 5 ], while patients with ES disease have poor mOS of 10–13 months and 5-year survival rates of < 5% [ 1 , 6 , 7 ]. Smoking is known to be the primary risk factor for SCLC [ 6 ], and therefore, smoking prevention or cessation are key strategies to diminish the clinical impact of the disease.…”

Construction and Validation of a Novel Nomogram to Predict the Overall Survival of Patients With Combined Small Cell Lung Cancer: A Surveillance, Epidemiology, and End Results Population-Based Study

“…Only 10.9% of cases developed brain metastasis, which is similar to the biological behavior of P-SCLC. 18,19 Furthermore, multivariate analysis revealed that brain metastasis and liver metastasis were correlated with unfavorable OS in C-SCLC. Therefore, consistent with P-SCLC, liver metastasis [20][21][22] and brain metastasis 23 are also crucial negative prognostic factors of OS for patients with C-SCLC.…”

Role of interventional bronchoscopy and chemotherapy in the treatment of patients with small-cell lung cancer: A case report

“…Data from the International Association for the Study of Lung Cancer 1 show that the 2-year overall survival rate of the SCLC group of stages I, II, III, and IV is about 73%, 54%, 23%, and 8%, respectively. Data from Spain 2 indicate that 96.7% of SCLC patients could be present with metastases, with approximately 20% having brain metastases at the time of diagnosis. The overall survival was about 9.5 months, with the 1-year and 2-year survival rates being 38.9% and 14.8%, respectively.…”