Role of adjuvant therapy in early-stage small-cell lung cancer: comment on a population-based cohort study of patients with early-stage small-cell lung cancer

Saji, Hisashi; Marushima, Hideki; Nakamura, Hiroki

doi:10.21037/jtd.2016.10.58

Cited by 4 publications

(5 citation statements)

References 8 publications

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“…Median 5-years survival rates up to 50 % have been reported in stage I and II SCLC patients receiving surgery and adjuvant therapy [9,34]. Despite complete R0 resection, the application of adjuvant treatment has been reported to represent one of the key-factors for optimal long-term results [35]. This is in line with the findings in our surgical study cohort, where adjuvant chemotherapy was a clear independent prognostic factor of improved OS and DFS.…”

Section: Discussionsupporting

confidence: 90%

Lymphocyte-to-monocyte ratio is an independent prognostic factor in surgically treated small cell lung cancer: An international multicenter analysis

Lang¹,

Egger²,

Hoda³

et al. 2022

Lung Cancer

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Section: Discussionsupporting

confidence: 90%

Lymphocyte-to-monocyte ratio is an independent prognostic factor in surgically treated small cell lung cancer: An international multicenter analysis

Lang¹,

Egger²,

Hoda³

et al. 2022

Lung Cancer

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“…21 Surgery is to be part of a combined modality approach because surgery alone has inferior results. 26,27 In our study, patients who underwent surgery followed by adjuvant chemotherapy had a significantly longer survival time than those who did not receive adjuvant chemotherapy (median 84 months versus 31 months, p ¼ 0.043; 5-year survival rates 51.2% versus 43.8%, respectively).…”

Section: Discussionmentioning

confidence: 57%

Surgical Resection of SCLC: Prognostic Factors and the Tumor Microenvironment

Zhao

Kallakury

Chahine

et al. 2019

Journal of Thoracic Oncology

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Introduction: Surgery in SCLC is limited to very early stages, but several reports suggest a potential broader role. Little is known of the influence of microenvironment on the biology of SCLC. Methods:We assessed the clinical prognostic factors in a large series of resected SCLC patients. The prognostic value of programmed cell death ligand 1 (PD-L1) expression in tumor cells and tumor infiltrating lymphocytes (TILs) and the percentage of CD3-, CD20-, CD45-and CD68-positive cells, were also investigated.Results: Two hundred five SCLC cases were resected between 2005 and 2015 and the median follow-up was 29 months (range: 2 to 135 months). Median survival of all patients was 69 months, and 5-year survival rates were 63.8%, 65.5%, 34.9%, and 0% for pathologic stages I, II, III, and IV, respectively. By multivariate analysis complete resection, cigarette index, lymph node metastatic rate, percentage of CD3-positive cells, PD-L1 expression in tumor cells, and TILs were independent prognostic factors. High PD-L1 expression was present in 3.2% and 33.5% of all tumor samples in tumor cells and TILs, respectively. High PD-L1 expression in tumor cells or TILs correlated with shorter survival, whereas high expression of CD3, CD20, and CD45 correlated with better survival.Conclusions: Resected stage II SCLC patients have similar survival as stage I, suggesting that surgery could be extended to patients with hilar lymph node involvement. Survival was better in tumors with a higher percentage of T cells and B cells, whereas PD-L1 expression in tumor cells and TILs correlated with worse survival, which suggests a potential role of immunotherapy in resected SCLC.

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“…The topic of sublobar resection versus lobectomy for stage I tumors smaller than 20 mm is controversial in NSCLC, 5–7 while lobectomy seems to be superior to sublobar resection even for early‐stage SCLC 8 . Furthermore, adjuvant chemotherapy is indicated for stage II or III NSCLC 9 while retrospective studies support the routine administration of adjuvant therapy even for stage I SCLC 10–12 . Previous papers, 13–23 summarized in Table 4, evaluated several prognostic factors as the extent of resection, the administration of adjuvant chemotherapy, and the expression of immunoistochemical neuroendocrine markers to define the best treatment of LCNEC in relation to its clinical and pathological characteristics.…”

Section: Discussionmentioning

confidence: 99%

“… 8 Furthermore, adjuvant chemotherapy is indicated for stage II or III NSCLC 9 while retrospective studies support the routine administration of adjuvant therapy even for stage I SCLC. 10 , 11 , 12 Previous papers, 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 summarized in Table 4 , evaluated several prognostic factors as the extent of resection, the administration of adjuvant chemotherapy, and the expression of immunoistochemical neuroendocrine markers to define the best treatment of LCNEC in relation to its clinical and pathological characteristics. However, the results were contrast as the exisisting studies were heterogenous.…”

Section: Discussionmentioning

confidence: 99%

Adjuvant chemotherapy, extent of resection, and immunoistochemical neuroendocrine markers as prognostic factors of early‐stage large‐cell neuroendocrine carcinoma

Andreetti¹,

Ibrahim²,

Gagliardi³

et al. 2022

Thoracic Cancer

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Background We investigated whether adjuvant chemotherapy, extent of resection, and immunoistochemical neuroendocrine markers affected survival of patients with the early stage of large‐cell neuroendocrine cancer. Methods This was a retrospective multicenter study including consecutive patients undergoing resection of node negative large‐cell neuroendocrine carcinoma. Five‐year survival and disease‐free survival rate were evaluated by the Kaplan–Meier method and the log‐rank test in relation to adjuvant chemotherapy, extent of resection, and immunoistochemical neuroendocrine markers (synaptophysin, chromogranin A, and neuron‐specific enolase). Results Our study population included 117 patients; 47 (40%) of these received adjuvant chemotherapy. Patients treated with adjuvant chemotherapy had better survival (74% vs. 45%, p = 0.002) and disease‐free survival (79% vs. 40%, p = 0.001) in all cases except patients with tumor <20 mm (79.5% vs. 57.4%, p = 0.43). Lobectomy compared to sublobar resection was associated with better survival (67% vs. 0.1%, p < 0.0001) and disease‐free survival (65% vs. 0.1%, p < 0.0001) also in patients with tumor <20 mm (79% vs. 28%, p = 0.001). Patients with triple‐positive neuroendocrine markers had better survival (79% vs. 35%, p = 0.0001) and disease‐free survival (69% vs. 42%, p = 0.0008). Regression analysis showed that tumor size <20 mm, lobectomy, adjuvant chemotherapy, and triple‐positive immunistochemical neuroendocrine markers were significant favorable prognostic factors for survival outcomes. Conclusions Lobectomy seems to be the management of choice in patients with large‐cell neuroendocrine cancer <20 mm while adjuvant chemotherapy should be administered only in patients with tumor >20 mm.

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Role of adjuvant therapy in early-stage small-cell lung cancer: comment on a population-based cohort study of patients with early-stage small-cell lung cancer

Cited by 4 publications

References 8 publications

Lymphocyte-to-monocyte ratio is an independent prognostic factor in surgically treated small cell lung cancer: An international multicenter analysis

Lymphocyte-to-monocyte ratio is an independent prognostic factor in surgically treated small cell lung cancer: An international multicenter analysis

Surgical Resection of SCLC: Prognostic Factors and the Tumor Microenvironment

Adjuvant chemotherapy, extent of resection, and immunoistochemical neuroendocrine markers as prognostic factors of early‐stage large‐cell neuroendocrine carcinoma

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