nach oben

Journal of Cancer Research and Clinical Oncology

Erschienen in:

13.07.2019 | Original Article – Clinical Oncology

Effects of surgery on survival of elderly patients with stage I small-cell lung cancer: analysis of the SEER database

verfasst von: Yan Li, Song Hu, Jun Xie, Xian Zhang, Yun Zong, Bin Xu, Chong Li

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 9/2019

Einloggen, um Zugang zu erhalten

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.

Abdel-Rahman O (2018) Changing epidemiology of elderly small cell lung cancer patients over the last 40 years; a SEER database analysis. Clin Respir J 12:1093–1099. https://doi.org/10.1111/crj.12632 CrossRefPubMed

Ahmed Z, Kujtan L, Kennedy KF, Davis JR, Subramanian J (2017) Disparities in the management of patients with stage I small cell lung carcinoma (SCLC): a surveillance, epidemiology and end results (SEER) analysis. Clin Lung Cancer 18:e315–e325. https://doi.org/10.1016/j.cllc.2017.03.003 CrossRefPubMed

Asmis TR et al (2008) Age and comorbidity as independent prognostic factors in the treatment of non small-cell lung cancer: a review of National Cancer Institute of Canada Clinical Trials Group trials. J Clin Oncol 26:54–59. https://doi.org/10.1200/JCO.2007.12.8322 CrossRefPubMed

Che K et al (2018) Survival outcomes for patients with surgical and non-surgical treatments in stages I–III small-cell lung cancer. J Cancer 9:1421–1429. https://doi.org/10.7150/jca.23583 CrossRefPubMedPubMedCentral

Dalwadi SM, Szeja SS, Bernicker EH, Butler EB, Teh BS, Farach AM (2018) Practice patterns and outcomes in elderly stage I non-small-cell lung cancer: a 2004 to 2012 SEER analysis. Clin Lung Cancer 19:e269–e276. https://doi.org/10.1016/j.cllc.2017.11.004 CrossRefPubMed

Ganti AK et al (2016) Early stage non-small-cell lung cancer in octogenarian and older patients: a SEER database analysis. Clin Lung Cancer 17:285–291. https://doi.org/10.1016/j.cllc.2015.11.014 CrossRefPubMed

Govindan R et al (2006) Changing epidemiology of small-cell lung cancer in the United States over the last 30 years: analysis of the surveillance, epidemiologic, and end results database. J Clin Oncol 24:4539–4544. https://doi.org/10.1200/jco.2005.04.4859 CrossRefPubMed

Kalemkerian GP et al (2018) NCCN guidelines insights: small cell lung cancer, version 2.2018. J Natl Compr Cancer Netw 16:1171–1182. https://doi.org/10.6004/jnccn.2018.0079 CrossRef

Lally BE et al (2009) Trends in the outcomes for patients with limited stage small cell lung cancer: an analysis of the surveillance, epidemiology, and end results database. Lung Cancer 64:226–231. https://doi.org/10.1016/j.lungcan.2008.08.010 CrossRefPubMed

Lim E, Belcher E, Yap YK, Nicholson AG, Goldstraw P (2008) The role of surgery in the treatment of limited disease small cell lung cancer: time to reevaluate. J Thorac Oncol 3:1267–1271. https://doi.org/10.1097/JTO.0b013e318189a860 CrossRefPubMed

Matsuoka H, Okada M, Sakamoto T, Tsubota N (2005) Complications and outcomes after pulmonary resection for cancer in patients 80 to 89 years of age. Eur J Cardiothorac Surg 28:380–383. https://doi.org/10.1016/j.ejcts.2005.06.010 CrossRefPubMed

Okami J et al (2009) Pulmonary resection in patients aged 80 years or over with clinical stage I non-small cell lung cancer: prognostic factors for overall survival and risk factors for postoperative complications. J Thorac Oncol 4:1247–1253. https://doi.org/10.1097/jto.0b013e3181ae285d CrossRefPubMed

Pal SK, Hurria A (2010) Impact of age, sex, and comorbidity on cancer therapy and disease progression. J Clin Oncol 28:4086–4093. https://doi.org/10.1200/jco.2009.27.0579 CrossRefPubMed

Port JL, Kent M, Korst RJ, Lee PC, Levin MA, Flieder D, Altorki NK (2004) Surgical resection for lung cancer in the octogenarian. Chest 126:733–738. https://doi.org/10.1378/chest.126.3.733 CrossRefPubMed

Rostad H, Strand TE, Naalsund A, Talleraas O, Norstein J (2006) Lung cancer surgery: the first 60 days. A population-based study. Eur J Cardiothorac Surg 29:824–828. https://doi.org/10.1016/j.ejcts.2006.01.055 CrossRefPubMed

Schreiber D et al (2010) Survival outcomes with the use of surgery in limited-stage small cell lung cancer: should its role be re-evaluated? Cancer 116:1350–1357. https://doi.org/10.1002/cncr.24853 CrossRefPubMed

Siegel RL, Miller KD (2018) Jemal A (2018) Cancer statistics. CA Cancer J Clin 68:7–30. https://doi.org/10.3322/caac.21442 CrossRefPubMed

Takei H et al (2014) Surgery for small cell lung cancer: a retrospective analysis of 243 patients from Japanese Lung Cancer Registry in 2004. J Thorac Oncol 9:1140–1145. https://doi.org/10.1097/jto.0000000000000226 CrossRefPubMed

Weksler B, Nason KS, Shende M, Landreneau RJ, Pennathur A (2012) Surgical resection should be considered for stage I and II small cell carcinoma of the lung. Ann Thorac Surg 94:889–893. https://doi.org/10.1016/j.athoracsur.2012.01.015 CrossRefPubMed

Yu JB, Decker RH, Detterbeck FC, Wilson LD (2010) Surveillance epidemiology and end results evaluation of the role of surgery for stage I small cell lung cancer. J Thorac Oncol 5:215–219. https://doi.org/10.1097/JTO.0b013e3181cd3208 CrossRefPubMed

Titel: Effects of surgery on survival of elderly patients with stage I small-cell lung cancer: analysis of the SEER database
verfasst von: Yan Li
Song Hu
Jun Xie
Xian Zhang
Yun Zong
Bin Xu
Chong Li
Publikationsdatum: 13.07.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Cancer Research and Clinical Oncology / Ausgabe 9/2019
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-019-02976-2

Neu im Fachgebiet Onkologie

18.04.2024 | Wirbelsäulenmetastase | Nachrichten

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Effects of surgery on survival of elderly patients with stage I small-cell lung cancer: analysis of the SEER database

Abstract

Introduction

Patients and methods

Results

Conclusion

Neu im Fachgebiet Onkologie

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Adjuvante Brustkrebstherapie: Doppelt hält besser

Manche Gestagene können das Risiko für Meningeome erhöhen

Einladung zum PSA-Screening senkt die Krebssterblichkeit

Update Onkologie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Introduction

Patients and methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 9/2019

Possible correlation of sonic hedgehog signaling with epithelial–mesenchymal transition in muscle-invasive bladder cancer progression

Impacts of thoracoscopic surgery and high grade histologic subtypes on spread through air spaces in small stage I lung adenocarcinomas

Heterozygous loss of keratinocyte TRIM16 expression increases melanocytic cell lesions and lymph node metastasis

Adjuvant carboplatin therapy in patients with clinical stage 1 testicular seminoma: is long-term morbidity increased?

A comparison of regorafenib and fruquintinib for metastatic colorectal cancer: a systematic review and network meta-analysis

A systematic review of head-to-head trials of approved monoclonal antibodies used in cancer: an overview of the clinical trials agenda

Neu im Fachgebiet Onkologie

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Adjuvante Brustkrebstherapie: Doppelt hält besser

Manche Gestagene können das Risiko für Meningeome erhöhen

Einladung zum PSA-Screening senkt die Krebssterblichkeit

Update Onkologie