Surgical outcomes in patients with small cell lung cancer: comparative analysis of computed tomograpy-detected patients with others

Abstract

BackgroundIt is shown that low-dose computed tomography (CT) screening is useful for a reduction in lung-cancer-specific mortality in heavy smokers. However, the information about effectiveness according to the histological types of lung cancer has not been adequately investigated especially small cell lung cancer (SCLC). The present study was performed to see the clinical benefit of CT screening in patients with SCLC following thoracotomy.MethodsWe retrospectively reviewed the outcome in patients with early stage SCLC who initially underwent thoracotomy. The clinical stages and actuarial survival were estimated according to the three means of detection of SCLC: chest CT, radiographic screen, and symptomatically prompted cases.ResultsSixty-nine patients (men/women, 63/6; mean age, 70 years) with SCLC underwent thoracotomy between 1991 and 2010 including chest CT (n = 13), radiographic screening (n = 39), and symptomatically prompted cases (n = 17). Pathological staging information included stage IA (n = 25), IB (n = 8), IIA (n = 13), IIB (n = 5), IIIA (n = 11), and IIIB (n = 7). Median survival time was 30.0 (95% confidence interval (CI): 22.0 to 57.0) months, with overall survival at 5 years of 34.3% (95% CI, 23.47 to 47.3). Nine patients (69%) with stage I were detected by CT which was significantly higher than those in other detection arms. However, there were no significant differences in the survival between CT and other detection arms.ConclusionsCT examination may be useful for detection in early stage SCLC potentially suitable for surgery, but the contribution to better clinical outcome in patients with SCLC remains unclear.

Induction chemotherapy in patients with resectable laryngeal cancer: A meta-analysis

“…However, this conclusion may differ among different studies. Jie et al ( 3 ) also reported that the IC group had a lower rate of distant metastasis by 8% (95% CI: 1–16, P=0.02). Furthermore, a randomized phase 3 trial ( 37 ) divided patients into two groups, one receiving IC followed by concurrent chemoradiotherapy (n=70), and the other receiving concurrent chemoradiotherapy alone (n=75); finally, 5 (7%) patients in the induction group and 8 (11%) in the concurrent chemoradiotherapy group developed distant metastasis.…”

“…Induction chemotherapy (IC) is considered as a reliable approach to controlling locally advanced LC, increasing the rate of laryngeal preservation and decreasing the risk of local spread or distant metastasis, thereby increasing the therapeutic efficacy. However, locoregional control must be performed in accordance with the tumor borders following IC, which should be marked at the start of the therapy ( 3 ), regardless of the response to IC. The clinical value of IC remains a matter of debate, particularly in cases with resectable advanced LC.…”

Effects of Surgery on Survival of Early-Stage Patients With SCLC: Propensity Score Analysis and Nomogram Construction in SEER Database

“…While other studies have suggested that the poor efficacy of current treatment options for disease progression is related to the lack of benefit of early diagnosis, as such subjects do not usually have the option of surgery, as systemic spread and paraneoplastic syndrome typically impede the therapeutic potential of resection (32). Improved or favorable survival rates in patients with resected SCLC have been described in recent retrospective analyses (33,34), indicating that surgery is associated with improved survival for certain patients with early-stage SCLC (35). The results of the present study are almost identical to that of these previous studies (36).…”

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

“…According to National Comprehensive Cancer Network (NCCN) guidelines, surgery is only recommended in patients with stage I–IIA (T1–2, N0, M0) SCLC after standard clinical staging evaluation. These patients without lymph node involvement can benefit from surgical resection, which is associated with a median survival of 35–79 months [ 5 – 10 ]. Surgery with adjuvant chemotherapy can also improve long-term survival compared to concurrent chemoradiation.…”