Hiroshi Yokouchi1, Takashi Ishida2, Shigeo Yamazaki3, Hajime Kikuchi4, Satoshi Oizumi5, Hidetaka Uramoto6, Fumihiro Tanaka7, Masao Harada8, Kenji Akie9, Fumiko Sugaya10, Yuka Fujita11, Tatsuro Fukuhara12, Kei Takamura13, Tetsuya Kojima14, Toshiyuki Harada15, Mitsunori Higuchi16, Yoshifumi Matsuura17, Osamu Honjo18, Yoshinori Minami19, Naomi Watanabe20, Hiroshi Nishihara21, Hiroyuki Suzuki22, Hirotoshi Dosaka-Akita23, Hiroshi Isobe24, Masaharu Nishimura25, Mitsuru Munakata26. 1. Department of Pulmonary Medicine, Fukushima Medical University, Fukushima 960-1295, Japan. Electronic address: hyokouch@gmail.com. 2. Department of Pulmonary Medicine, Fukushima Medical University, Fukushima 960-1295, Japan; Clinical Oncology Center, Fukushima Medical University Hospital, Fukushima 960-1295, Japan. Electronic address: taku.ishida@nifty.ne.jp. 3. Department of Thoracic Surgery, Sapporo Keiyukai Hospital, Sapporo 003-0027, Japan. Electronic address: shigeoy@coral.ocn.ne.jp. 4. First Department of Medicine, Hokkaido University School of Medicine, 060-8638 Sapporo, Japan. Electronic address: hajime1first@yahoo.co.jp. 5. First Department of Medicine, Hokkaido University School of Medicine, 060-8638 Sapporo, Japan. Electronic address: soizumi@med.hokudai.ac.jp. 6. Second Department of Surgery, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan; Division of Thoracic Surgery, Saitama Cancer Center, Ina 362-0806, Japan. Electronic address: hidetaka@cancer-c.pref.saitama.jp. 7. Second Department of Surgery, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan. Electronic address: ftanaka@med.uoeh-u.ac.jp. 8. Department of Respiratory Medicine, National Hospital Organization Hokkaido Cancer Center, Sapporo 003-0804, Japan. Electronic address: mharada@sap-cc.go.jp. 9. Department of Respiratory Disease, Sapporo City General Hospital, Sapporo 060-8604, Japan. Electronic address: kenji.akie@doc.city.sapporo.jp. 10. Department of Respiratory Medicine, Teine Keijinkai Hospital, Sapporo 006-8555, Japan. Electronic address: fsugaya@r5.dion.ne.jp. 11. Department of Respiratory Medicine, National Hospital Organization Asahikawa Medical Center, Asahikawa 070-8644, Japan. Electronic address: yuka-1@hosp.go.jp. 12. Department of Respiratory Medicine, Miyagi Cancer Center, Natori 981-1293, Japan. Electronic address: fukuhara-tatsuro@miyagi-pho.jp. 13. First Department of Medicine, Obihiro Kosei Hospital, Obihiro 080-0016, Japan. Electronic address: keitak@hokkaido.med.or.jp. 14. Department of Medical Oncology, KKR Sapporo Medical Center, Sapporo 062-0931, Japan. Electronic address: kotetsu@kkr-smc.com. 15. Center for Respiratory Diseases, JCHO Hokkaido Hospital, Sapporo 062-8618, Japan. Electronic address: harada-toshiyuki@hokkaido.jcho.go.jp4. 16. Department of Thoracic Surgery, Fukushima Red Cross Hospital, Fukushima 960-8530, Japan; Department of Thoracic Surgery, Fukushima Medical University, Fukushima 960-1295, Japan. Electronic address: higuchi@fmu.ac.jp. 17. Center of Respiratory Disorders, Ohta Nishinouchi Hospital, Koriyama 963-8558, Japan. Electronic address: sleepy7@ohta-hp.or.jp. 18. Department of Respiratory Medicine, Sapporo-Kosei General Hospital, Sapporo 060-0033, Japan. Electronic address: tourbillon@w7.dion.ne.jp. 19. Respiratory Center, Asahikawa Medical University, Asahikawa 078-8510, Japan. Electronic address: yminami@asahikawa-med.ac.jp. 20. Department of Internal Medicine, Sunagawa City Medical Center, Sunagawa 073-0196, Japan. Electronic address: naomiwatanabe1961@gmail.com. 21. Department of Translational Pathology, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan. Electronic address: hnishihara@med.hokudai.ac.jp. 22. Department of Thoracic Surgery, Fukushima Medical University, Fukushima 960-1295, Japan. Electronic address: hiro@fmu.ac.jp. 23. Department of Medical Oncology, Hokkaido University Graduate School of Medicine, 060-8638 Sapporo, Japan. Electronic address: hdakita@med.hokudai.ac.jp. 24. Department of Medical Oncology, KKR Sapporo Medical Center, Sapporo 062-0931, Japan. Electronic address: h-isobe@kkr-smc.com. 25. First Department of Medicine, Hokkaido University School of Medicine, 060-8638 Sapporo, Japan. Electronic address: ma-nishi@med.hokudai.ac.jp. 26. Department of Pulmonary Medicine, Fukushima Medical University, Fukushima 960-1295, Japan. Electronic address: munakata@fmu.ac.jp.
Abstract
OBJECTIVES: Several American and Japanese guidelines recommend surgery for patients with c-stage I small-cell lung cancer (SCLC), whereas the European Society of Medical Oncology (ESMO) guidelines recommend surgery for patients with not only c-stage I but also c-stage II (T2N1) SCLC. In addition, previous studies identified various factors other than clinical stage that are related to survival in these patients. Thus, further validation and examination of the association of clinical stage and other clinical variables with survival are required for establishing practical management of early-stage SCLC. PATIENTS AND METHODS: We reviewed the clinical courses of 156 SCLC patients who had undergone surgery at 17 institutions between January 2003 and January 2013. RESULTS: Clinical stages (tumor-node-metastasis [TNM] version 7) of the 156 patients were 98 cases in IA, 14 in IB, 16 in IIA, 7 in IIB, 18 in IIIA, and 3 in IIIB. Median overall survival (OS) was 33.3 months (95% confidence interval: 20.9-45.8). Multivariate analysis revealed that OS was longer in patients either at c-stage II and under, with a maximum tumor diameter of <20mm, with preoperative diagnosis, without a history or presence of other types of cancer, or who underwent prophylactic cranial irradiation (PCI). CONCLUSION: These results indicate that a history or presence of other types of cancer might be a major decisive factor for surgery. Patients with c-stages I and II (c-T2N1) can be considered for surgery, and PCI may be useful in patients undergoing surgery in a practical setting, partly supporting the ESMO guidelines.(1).
OBJECTIVES: Several American and Japanese guidelines recommend surgery for patients with c-stage I small-cell lung cancer (SCLC), whereas the European Society of Medical Oncology (ESMO) guidelines recommend surgery for patients with not only c-stage I but also c-stage II (T2N1) SCLC. In addition, previous studies identified various factors other than clinical stage that are related to survival in these patients. Thus, further validation and examination of the association of clinical stage and other clinical variables with survival are required for establishing practical management of early-stage SCLC. PATIENTS AND METHODS: We reviewed the clinical courses of 156 SCLCpatients who had undergone surgery at 17 institutions between January 2003 and January 2013. RESULTS: Clinical stages (tumor-node-metastasis [TNM] version 7) of the 156 patients were 98 cases in IA, 14 in IB, 16 in IIA, 7 in IIB, 18 in IIIA, and 3 in IIIB. Median overall survival (OS) was 33.3 months (95% confidence interval: 20.9-45.8). Multivariate analysis revealed that OS was longer in patients either at c-stage II and under, with a maximum tumor diameter of <20mm, with preoperative diagnosis, without a history or presence of other types of cancer, or who underwent prophylactic cranial irradiation (PCI). CONCLUSION: These results indicate that a history or presence of other types of cancer might be a major decisive factor for surgery. Patients with c-stages I and II (c-T2N1) can be considered for surgery, and PCI may be useful in patients undergoing surgery in a practical setting, partly supporting the ESMO guidelines.(1).
Authors: Mathijs L Tomassen; Mieke J Aarts; Max Peters; Anne van Lindert; Dirk K M De Ruysscher; Joost J C Verhoeff; Peter S N van Rossum Journal: Clin Transl Radiat Oncol Date: 2021-02-12