Surgery is controversial in limited-stage small-cell lung cancer (LS-SCLC) (except for T1-2, N0M0). This study aimed to analyze the survival of LS-SCLC patients with proximal lobe (N1) lymph node metastases after surgery and appropriate postoperative adjuvant treatment.
Patients and Methods
We reviewed and followed up medical history and survival data of LS-SCLC patients from June 2007 to June 2016, and a total of 68 pathological stage N1 (p-N1) patients who underwent surgical resection and 71 clinical-stage N1 (c-N1) patients who received chemoradiotherapy were included in the final analysis.
The median follow-up of all the patients was 99.30 months. The median disease-free survival (DFS) of the surgery group was 13.567 months, and the median overall survival (OS) of the surgery and chemoradiotherapy groups were 29.600 months and 21.133 months (P-value < .001), respectively. The 2- and 5-year survival rates of the surgery group were 55.9% and 33.7%, and the 2- and 5-year survival rates of the chemoradiotherapy group were 39.8% and 9.4%, respectively. Meanwhile, postoperative thoracic radiotherapy appeared to be associated with a good prognosis (median OS 36.400 vs. 21.333 months, P-value .048), as did prophylactic cranial irradiation (median OS 50.867 vs. 22.600 months, P-value .007) in the surgery group.
Surgery may benefit patients with p-N1 SCLC, and in combination with appropriate postoperative adjuvant treatment, surgery may be a new therapeutic modality for SCLC.
Abbreviations:SCLC (small-cell lung cancer), LS (limited-stage), p-N1 (pathological stage N1), c-N1 (clinical-stage N1), TNM (tumor-node-metastasis), AJCC (the American Joint Committee on Cancer), DFS (disease-free survival), OS (overall survival), c-ⅡB (clinical-stage ⅡB), EP/EC (etoposide + cisplatin/carboplatin), TRT (thoracic radiation therapy), PCI (prophylactic cranial irradiation), CI (confidence interval), 3-year LRR rate (3-year local-regional recurrence rate), SEER (Surveillance, Epidemiology, and End Results), MRI (magnetic resonance imaging)
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Published online: August 14, 2022
Accepted: August 8, 2022
Received in revised form: July 12, 2022
Received: November 16, 2021
L.Y, J.X. contribute equally to this article.
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