This study summarized and analyzed the clinical characteristics and prognosis of small-cell lung cancer (SCLC) patients after surgical treatment. The clinical data of 130 patients (99 males and 31 females) with SCLC treated by surgery and confirmed by postoperative pathological examination at Peking Union Medical College Hospital from April 2004 to April 2019 were retrospectively analyzed. Clinical characteristics, surgery, pathological stage, and perioperative treatment were summarized. Kaplan–Meier survival curve and Cox regression analysis were performed. Pathological examination revealed that 36 (27.69%) patients had stage I SCLC, 22 (16.92%) patients had stage II SCLC, 65 (50.00%) patients had stage III SCLC, and 7 (5.39%) patients had stage IV SCLC. The overall median survival time was 50 months (95% confidence interval, 10.8–89.2 months). The median survival time of stage I, II, III and IV SCLC patients was 148, 42, 32, and 10 months, respectively. In patients who underwent surgical treatment, postoperative adjuvant therapy and tumor stage were independent prognostic factors for survival (p < 0.05).Lobectomy and lymph nodes resection combined with adjuvant therapy were cautiously recommended for stage I–IIIa SCLC patients.
KahnertKKauffmann-GuerreroDHuberRM.SCLC–state of the art and what does the future have in store?Clin Lung Cancer2016; 17(5): 325–333.
2.
KatoYFergusonTBBennettDE, et al. Oat cell carcinoma of the lung. A review of 138 cases. Cancer1969; 23(3): 517–524.
3.
van MeerbeeckJPFennellDADe RuysscherDKM.Small-cell lung cancer. Lancet2011; 378(9804): 1741–1755.
4.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Small Cell Lung Cancer (version 2.2015). Fort Washington, PA: National Comprehensive Cancer Network, 2015.
5.
LahiriAMajiAPotdarPD, et al. Lung cancer immunotherapy: progress, pitfalls, and promises. Mol Cancer2023; 22(1): 40.
6.
HwangSHongTHKimHK, et al. Whole-section landscape analysis of molecular subtypes in curatively resected small cell lung cancer: clinicopathologic features and prognostic significance. Mod Pathol2023; 36(7): 100184.
7.
MeijerJ-JLeonettiAAiròG, et al. Small cell lung cancer: novel treatments beyond immunotherapy. Semin Cancer Biol2022; 86(Pt 2): 376–385.
8.
BelluominiLCalvettiLInnoA, et al. SCLC treatment in the immuno-oncology era: current evidence and unmet needs. Front Oncol2022; 12: 840783.
9.
PetrellaFBardoniCCasiraghiM, et al. The role of surgery in high-grade neuroendocrine cancer: indications for clinical practice. Front Med (Lausanne)2022; 9: 869320.
10.
MartucciNMorabitoALa RoccaA, et al. Surgery in small-cell lung cancer. Cancers (Basel)2021; 13(3): 390.
11.
LababedeOMezianeMRiceT.Seventh edition of the cancer staging manual and stage grouping of lung cancer: quick reference chart and diagrams. Chest2011; 139(1): 183–189.
12.
FoxWScaddingJG.Medical research council comparative trial of surgery and radiotherapy for primary treatment of small-celled or oat-celled carcinoma of bronchus. Ten-year follow-up. Lancet1973; 2(7820): 63–65.31
13.
LadTPiantadosiSThomasP, et al. A prospective randomized trial to determine the benefit of surgical resection of residual disease following response of small cell lung cancer to combination chemotherapy. Chest1994; 106(6 Suppl): 320S–323S.
14.
KoinisFKotsakisAGeorgouliasV.Small cell lung cancer (SCLC): no treatment advances in recent years. Transl Lung Cancer Res2016; 5(1): 39–50.
15.
BarnesHSeeKBarnettS, et al. Surgery for limited-stage small-cell lung cancer. Cochrane Database Syst Rev2017; 4: CD011917.
16.
YangCFJChanDYSpeicherPJ, et al. Surgery versus optimal medical management for N1 small cell lung cancer. Ann Thorac Surg2017; 103(6): 1767–1772.
17.
CheKShenHQuX, et al. Survival outcomes for patients with surgical and non-surgical treatments in stages I-III small-cell lung cancer. J Cancer2018; 9(8): 1421–1429.
18.
YangYYuanGZhanC, et al. Benefits of surgery in the multimodality treatment of stage IIB-IIIC small cell lung cancer. J Cancer2019; 10(22): 5404–5412.
19.
ZhangCLiCShangX, et al. Surgery as a potential treatment option for patients with stage III small-cell lung cancer: a propensity score matching analysis. Front Oncol2019; 9: 1339.
20.
XuLZhangGSongS, et al. Surgery for small cell lung cancer: a surveillance, epidemiology, and end results (SEER) survey from 2010 to 2015. Medicine2019; 98(40): e17214.
21.
SchreiberDRineerJWeedonJ, et al. Survival outcomes with the use of surgery in limited-stage small cell lung cancer: should its role be re-evaluated?Cancer2010; 116(5): 1350–1357.
22.
KalemkerianG.Small cell lung cancer. Semin Respir Crit Care Med2016;37(05):783-796.
23.
Rami-PortaRBolejackVGirouxDJ, et al. The IASLC lung cancer staging project: the new database to inform the eighth edition of the TNM classification of lung cancer. J Thorac Oncol2014; 9(11): 1618–1624.
24.
MickePFaldumAMetzT, et al. Staging small cell lung cancer: veterans administration lung study group versus international association for the study of lung cancer—what limits limited disease?Lung Cancer2002; 37(3): 271–276.
25.
WuAJGillisAFosterA, et al. Patterns of failure in limited-stage small cell lung cancer: implications of TNM stage for prophylactic cranial irradiation. Radiat Oncol2017; 125(1): 130–135.
26.
ZhuHBiYHanA, et al. Risk factors for brain metastases in completely resected small cell lung cancer: a retrospective study to identify patients most likely to benefit from prophylactic cranial irradiation. Radiat Oncol2014; 9(1): 216.
27.
LiuYShanLShenJ, et al. Choice of surgical procedure–lobectomy, segmentectomy, or wedge resection–for patients with stage T1-2N0M0 small cell lung cancer: a population-based study. Thorac Cancer2019; 10(4): 593–600.
28.
VarlottoJMRechtAFlickingerJC, et al. Lobectomy leads to optimal survival in early-stage small cell lung cancer: a retrospective analysis. J Thorac Cardiovasc Surg2011; 142(3): 538–546.
29.
YangHXuJYaoF, et al. Analysis of unexpected small cell lung cancer following surgery as the primary treatment. J Cancer Res Clin Oncol2018; 144(12): 2441–2447.
30.
PaximadisPBeebe-DimmerJLGeorgeJ, et al. Comparing treatment strategies for stage I small-cell lung cancer. Clin Lung Cancer2018; 19(5): e559–e565.
31.
LohinaiZBonannoLAksarinA, et al. Neutrophil–lymphocyte ratio is prognostic in early stage resected small-cell lung cancer. PeerJ2019; 7: e7232.
32.
ChenesseauJBourlardDCluzelA, et al. Intent-to-cure surgery for small-cell lung cancer in the era of contemporary screening and staging methods. Interact Cardiovasc Thorac Surg2020; 30(4): 541–545.
33.
ZhaoXKallakuryBChahineJJ, et al. Surgical resection of SCLC: prognostic factors and the tumor microenvironment. J Thorac Oncol2019; 14(5): 914–923.
34.
OkadaMTsubotaNYoshimuraM, et al. Prognosis of completely resected pn2 non–small cell lung carcinomas: what is the significant node that affects survival?J Thorac Cardiovasc Surg1999; 118(2): 270–275.
35.
MiyamotoMMorikawaTKagaK, et al. Subcarinal node is the significant node that affects survival in resected small cell lung cancer. Surg Today2006; 36(8): 671–675.
36.
LuchtenborgMRiazSPLimE, et al. Survival of patients with small cell lung cancer undergoing lung resection in England, 1998–2009. Thorax2014; 69(3): 269–273.
37.
WongATRineerJSchwartzD, et al. Assessing the impact of postoperative radiation therapy for completely resected limited-stage small cell lung cancer using the national cancer database. J Thorac Oncol2016; 11(2): 242–248.
38.
PengALiGXiongM, et al. Role of surgery in patients with early stage small-cell lung cancer. Cancer Manag Res2019; 11: 7089–7101.
39.
EngelhardtKECoughlinJMDeCampMM, et al. Survival after adjuvant radiation therapy in localized small cell lung cancer treated with complete resection. J Thorac Cardiovasc Surg2019; 158(6): 1665–1677.e2.
40.
ZhongLSuoJWangY, et al. Prognosis of limited-stage small cell lung cancer with comprehensive treatment including radical resection. World J Surg Oncol2020; 18(1): 27.
41.
WooJHKimMYLeeKS, et al. Resected pure small cell lung carcinomas and combined small cell lung carcinomas: histopathology features, imaging features, and prognoses. Am J Roentgenol2019; 212(4): 773–781.
42.
KanajiNSakaiKUedaY, et al. Peripheral-type small cell lung cancer is associated with better survival and higher frequency of interstitial lung disease. Lung Cancer2017; 108: 126–133.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
