Population-based outcomes for small cell lung cancer: impact of standard management policies in British Columbia

Laskin, Janessa; Erridge, Sara; Coldman, Andrew J.; D’yachkova, Yulia; Speers, Caroline; Westeel, Virginie; Hislop, T. Greg; Olivotto, Ivo A.; Murray, Nevin

doi:10.1016/j.lungcan.2003.07.004

Cited by 25 publications

(12 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…SCLC is the most aggressive form of pulmonary cancer and, without treatment, the median survival ranges from 2 to 4 months [1,2,3,4]. Unlike other cell types of lung cancer, SCLC is both chemosensitive and radiosensitive; however, most patients have a dismal prognosis.…”

Section: Introductionmentioning

confidence: 99%

Survival of Patients with Small Cell Lung Carcinoma in Taiwan

Kuo¹,

Lin²,

Yang³

et al. 2012

Oncology

View full text Add to dashboard Cite

Background: Small cell lung cancer (SCLC) is the most aggressive form of lung cancer. The prognosis for SCLC patients remains unsatisfactory despite advances in chemotherapy. In this study, we sought to clarify the prognosis and treatment patterns of patients with SCLC. Methods: A cohort comprising all patients diagnosed with SCLC between January 2004 and December 2006 was assembled from the Taiwan Cancer Database. Patients were followed up until December 31, 2009, to determine overall survival. Patient survival was estimated using the Kaplan-Meier method, and Cox’s proportional hazard model was used to determine the relationship between prognostic factors and median survival time. Results: Among the 1,684 patients diagnosed with SCLC, 1,215 (72%) were diagnosed with extensive-stage disease and 469 (28%) with limited-stage disease. Most of the patients were male (90%). The median survival duration of patients with limited-stage and extensive-stage SCLC was 10.3 months and 5.6 months, respectively. For limited-stage patients, surgery, chemotherapy, and combined chemotherapy and radiotherapy resulted in better survival than best supportive care (HR 0.20, p < 0.001; HR 0.61, p < 0.001, and HR 0.37, p < 0.001, respectively). For extensive-stage patients, male gender was significantly associated with a poor prognosis (HR 1.45, p < 0.001) and chemotherapy was shown to improve overall survival more effectively than best supportive care (HR 0.37, p < 0.001). Conclusion: For limited-stage SCLC patients, surgery, chemotherapy, and combined chemotherapy and radiotherapy improved survival compared to best supportive care. Extensive-stage SCLC patients benefited more from chemotherapy treatment than from best supportive care.

show abstract

Section: Introductionmentioning

confidence: 99%

Survival of Patients with Small Cell Lung Carcinoma in Taiwan

Kuo¹,

Lin²,

Yang³

et al. 2012

Oncology

View full text Add to dashboard Cite

show abstract

“…The median ranges of survival for LS-SCLC are 15 to 20 months. In the last a few decades, a modest yet significant improvement of the survival rate of LS-SCLC has been shown in North America and other countries (1–4). Some prognostic factors such as age, gender, smoking status, or different strategies of combined chemo-radiotherapy have been studied in LS-SCLC, but the role of some of these factors in predicting patients’ survival remains controversial.…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors for limited-stage small cell lung cancer: A study of 284 patients

Chen¹,

Jiang²,

Garces³

et al. 2010

Lung Cancer

View full text Add to dashboard Cite

Combined modality therapy is the standard care for limited stage-small cell lung cancer (LS-SCLC) and has led to a significant improvement in patients' survival. This study sought to investigate and define the importance of prognostic effects of known and controversial factors especially the impact of smoking status and treatment strategies. A total of 284 patients with LS-SCLC diagnosed and prospectively followed from 1997 to 2008 at Mayo Clinic; their characteristics and survival outcome were assessed on the basis of age, gender, smoking history, performance status (PS), tumor recurrence or progression, and treatment using Cox proportional hazards models. Our main results are as follows: (1) Although neither smoking status (former or current smokers) nor intensity (pack-years smoked) at the time of SCLC diagnosis were significant survival predictors, compared to continued smokers (who never quit smoking), patients who quit at or after diagnosis cut the risk of death by 45% (HR=0.55, 95% CI 0.38-0.79); patients who quit before lung cancer diagnosis also experienced survival benefit (HR=0.72, 95% CI 0.52-1.00). (2) Thoracic radiotherapy and platinum-based chemotherapy could significantly improve survival but the timing (within or after one month of diagnosis) of starting chemotherapy or radiation therapy did not. (3) After adjusting for other known factors, a lower PS did not predict poorer survival, suggesting PS should not be the only factor for

show abstract

“…The selection of 6 months as a cut off point to define referral was used to as a surrogate for involvement of an oncologist in the decision-making about primary therapy, and has been used in other population-based studies [10,12]. It is likely that referrals made after 6 months were for either very delayed adjuvant therapy, or more likely for treatment of relapse or metastases.…”

Section: Discussionmentioning

confidence: 99%

“…surgery, radiotherapy or chemotherapy) [7,8]. Assessment of stage and PS in population-based reports examining lung cancer prognosis usually relate to patients who have been staged by specialist after referral to a cancer centre or include a combination of specialist and generalist physicians [9][10][11][12][13]. To our knowledge there are no reports of prognostic factors in lung cancer patients at a population level based exclusively on general practitioner (GP) assessments.…”

Section: Introductionmentioning

confidence: 99%