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Conditional Survival of Patients with Limited-Stage Small Cell Lung Cancer After Surgery: A National Real-World Cohort Study

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The prognosis of limited-stage small cell lung cancer (LS-SCLC) after surgery usually is estimated at diagnosis, but how the prognosis actually evolves over time for patients who survived for a predefined time is unknown.

Methods

Data on patients with a diagnosis of LS-SCLC after surgery between 2004 and 2015 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. The 5-year conditional cancer-specific survival (CCSS) and conditional overall survival (COS) were calculated.

Results

This study analyzed 997 patients (555 women, 55.7%) with a median age, of 67 years (interquartile range [IQR], 60–73 years). The 5-year CCSS and COS increased from 44.7% and 38.3%, respectively, at diagnosis to 83.7% and 67.9% at 5 years after diagnosis. Although there were large differences with different stages (stages I, II, and III) at diagnosis (respectively 59.5%, 28.4%; 28.1% for CCSS and 50.6%, 24.8%, and 23.6% for COS), the gap decreased with time, and the rates were similar after 5 years (respectively 85.0%, 80.3%, and 79.4% for CCSS; 65.6%, 56.9%, and 61.3% for COS). The 5-year conditional survival for the patients who received lobectomy was better than for those who received sublobectomy or pneumonectomy. Multivariable analyses showed that only age and resection type were independent predictors for CCSS and COS, respectively, throughout the period.

Conclusion

Conditional survival estimates for LS-SCLC generally increased over time, with the most significant improvement in patients with advanced stage of disease. Resection type and old age represented extremely important determinants of prognosis after a lengthy event-free follow-up period.

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Data availability

All the data are available in a public, open-access repository.

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Contributions

Jun-Peng Lin, Shuo-Yan Liu, Feng Wang, and Xiao-Feng Chen contributed to the conception and design. Jun-Peng Lin, Pei-Yuan Wang, Hang Zhou, and Feng-Nian Zhuang collected and analyzed the data. Jun-Peng Lin, Yu-Jie Chen, Wen-Wei Wei, and Hao He drew the figures and tables. Jun-Peng Lin wrote the draft. Jun-Peng Lin, Wei-Jie Chen, Feng Wang, and Shuo-Yan Liu contributed to manuscript writing and revision. All authors read and approved the final manuscript.

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Correspondence to Shuo-Yan Liu MD or Feng Wang MD.

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Lin, JP., Chen, XF., Wang, P. et al. Conditional Survival of Patients with Limited-Stage Small Cell Lung Cancer After Surgery: A National Real-World Cohort Study. Ann Surg Oncol 31, 4250–4260 (2024). https://doi.org/10.1245/s10434-024-14983-w

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  • DOI: https://doi.org/10.1245/s10434-024-14983-w

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