Lei Chen1#, Linggen Gao2#, Tao Zhang1, Xi Liu1 and Yang Liu1*
1Department of Thoracic Surgery, General Hospital of Chinese People's Liberation Army, China
2Department of Comprehensive Surgery, General Hospital of Chinese People's Liberation Army, China
#These authors contributed equally to this work
Background: The role of surgery in limited stage Small Cell Lung Cancer (SCLC) remains a topic of debate. Survival outcomes for surgical resection of limited disease SCLC compared to nonsurgical treatment were examined. Methods: The study population included patients with histologically confirmed SCLC at the Department of Thoracic Surgery Chinese PLA General Hospital From 2005 to 2017. All the included patients were identified by either examination of pretreatment biopsy or final postoperative pathology reports. Patients with clinical stage IV or unknown clinical stage were excluded. Overall Survival (OS) was assessed using Kaplan-Meier and multivariable Cox models. Results: Two hundred and four clinical stages I-III SCLC patients, including 152 undergoing surgery, were included. Treatment consisted of surgery with adjuvant chemotherapy therapy in 49.0% (100/204), and surgery with adjuvant chemo-radiation therapy in 55% (52/204). Chemotherapy has been administered to all patients. The 5-year survival of the entire cohort was 32.7%. The overall survival rate at 1, 3, and 5 years stratified by pathologic stage were 96.9%, 81.8%, 70.3% (stage I), 95.9%, 60.3%, 32% (stage II), 80.9%, 13.6%, 0% (stage III), respectively. The median OS of patients with stage I was 106 months (95% CI 53.50–158.5 months). Surgery provided the greater survival benefit for patients with stage II (median OS, 76 months; 95% CI: 33.0–119.0 vs. 33 months; 95% CI: 27.2–38.8, P<0.0001) and stage III (median OS, 28.0 months; 95% CI: 25.4–30.6 vs. 18.0, 95% CI: 15.7–20.3, P=0.01). The independent predictors of morbidity include margin status (R1), male, clinical stage and smoking. Conclusion: There was a significant survival benefit for patients with limited stage SCLC in the operation group.
Chen L, Gao L, Zhang T, Liu X, Liu Y. Effect of Surgery on Clinical Outcomes on Limited-Stage Small Cell Lung Cancer. Clin Surg. 2021; 6: 3370.