Yan Li1, Song Hu1, Jun Xie1, Xian Zhang1, Yun Zong1, Bin Xu2, Chong Li3. 1. Department of Respiratory Medicine, The Third Affiliated Hospital of Soochow University, 185 Juqian Road, Changzhou, 213003, China. 2. Laboratory of Cancer Research, The Third Affiliated Hospital of Soochow University, 185 Juqian Road, Changzhou, 213003, China. 3. Department of Respiratory Medicine, The Third Affiliated Hospital of Soochow University, 185 Juqian Road, Changzhou, 213003, China. zeyou06@163.com.
Abstract
INTRODUCTION: Surgery improves survival of small-cell lung cancer (SCLC) patients in early stage. However, the role of surgery in the elderly stage I SCLC patients is not well established. We designed this retrospective study to explore the efficacy of surgery on survival of this subset population. PATIENTS AND METHODS: Elderly patients aged ≥ 75 years with stage I SCLC diagnosed histologically from 1998 to 2013 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Included patients were divided into surgery group (received surgery, accompanied by chemotherapy, radiotherapy, or both or neither), non-surgical group (only received radiotherapy, chemotherapy, or combination), and untreated group. Overall survival (OS) and lung cancer-specific survival (LCSS) were compared among the three groups by the Kaplan-Meier analysis. Cox proportional hazards regression was used to identify factors associated with survival. RESULTS: A total of 983 patients were included. Among all of the patients, 24.0% patients received surgery, 46.6% patients received non-surgical treatment, and 29.4% patients received no treatment. The 5-year OS rates of surgery, non-surgical and untreated groups were 31%, 12% and 6%, respectively (P < 0.0001). In multivariable analysis, surgery was an important factor that improved OS when compared with non-surgical treatment (HR 0.554; 95% CI 0.458-0.670 [P < 0.0001]). In subgroup analysis, surgery remained an independent factor for OS among patients aged 75-79 years (HR 0.506; 95% CI 0.391-0.655 [P < 0.0001]) and 80-84 years (HR 0.544; 95% CI 0.388-0.763 [P < 0.0001]), while did not reach statistical significance when compared to non-surgical treatment for patients age ≥ 85 years (HR 0.914; 95% CI 0.507-1.650; [P = 0.766]). CONCLUSION: Surgical resection significantly improved OS in stage I SCLC patients aged 75-84 years in our study, but further exploration in larger prospective clinical trials is needed.
INTRODUCTION: Surgery improves survival of small-cell lung cancer (SCLC) patients in early stage. However, the role of surgery in the elderly stage I SCLCpatients is not well established. We designed this retrospective study to explore the efficacy of surgery on survival of this subset population. PATIENTS AND METHODS: Elderly patients aged ≥ 75 years with stage I SCLC diagnosed histologically from 1998 to 2013 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Included patients were divided into surgery group (received surgery, accompanied by chemotherapy, radiotherapy, or both or neither), non-surgical group (only received radiotherapy, chemotherapy, or combination), and untreated group. Overall survival (OS) and lung cancer-specific survival (LCSS) were compared among the three groups by the Kaplan-Meier analysis. Cox proportional hazards regression was used to identify factors associated with survival. RESULTS: A total of 983 patients were included. Among all of the patients, 24.0% patients received surgery, 46.6% patients received non-surgical treatment, and 29.4% patients received no treatment. The 5-year OS rates of surgery, non-surgical and untreated groups were 31%, 12% and 6%, respectively (P < 0.0001). In multivariable analysis, surgery was an important factor that improved OS when compared with non-surgical treatment (HR 0.554; 95% CI 0.458-0.670 [P < 0.0001]). In subgroup analysis, surgery remained an independent factor for OS among patients aged 75-79 years (HR 0.506; 95% CI 0.391-0.655 [P < 0.0001]) and 80-84 years (HR 0.544; 95% CI 0.388-0.763 [P < 0.0001]), while did not reach statistical significance when compared to non-surgical treatment for patients age ≥ 85 years (HR 0.914; 95% CI 0.507-1.650; [P = 0.766]). CONCLUSION: Surgical resection significantly improved OS in stage I SCLCpatients aged 75-84 years in our study, but further exploration in larger prospective clinical trials is needed.
Entities:
Keywords:
Elderly; SEER; Small-cell lung cancer; Surgery
Authors: Bin Zhou; Qiuyuan Li; Linlin Qin; Zhao Li; Kaiqi Jin; Jie Dai; Yuming Zhu; Yang Yang; Salma K Jabbour; Alfredo Tartarone; Calvin S H Ng; Alfons Navarro; Cecilia Pompili; Gening Jiang Journal: Transl Lung Cancer Res Date: 2021-10