Role of surgery in a case-control study of patients with clinical stage IIIA small cell lung cancer.

Content Provider	Europe PMC
Author	Li, Shuangyi Jin, Kaiqi Pan, Yingying Wu, Chunxiao Ren, Shengxiang Jiang, Gening Zhang, Peng
Copyright Year	2021
Abstract	BackgroundThe role of surgery in the multidisciplinary treatment of clinical stage IIIA small cell lung cancer is yet to be verified. This study was performed to determine the benefit of surgery in patients with stage IIIA small cell lung cancer.MethodsPatients diagnosed with stage IIIA small cell lung cancer at Shanghai Pulmonary Hospital from 2005 to 2015 were included and divided into two groups: the surgery with neoadjuvant and adjuvant chemotherapy group and the concurrent chemo-radiotherapy group. Overall survival was compared between the two groups. A multivariate Cox regression model was constructed to evaluate factors associated with overall survival.ResultsOf 69 patients with stage IIIA small cell lung cancer during the study period, 40 patients (58%) underwent surgery with neoadjuvant and adjuvant chemotherapy, and 29 patients (42%) underwent concurrent chemo-radiotherapy. Patients in the surgery with neoadjuvant and adjuvant chemotherapy group had a longer overall survival compared with patients in the concurrent chemo-radiotherapy group (median survival: 33.1 vs. 16.2 months, respectively; 2-year overall survival: 44.2% vs. 14.9%, respectively; log-rank: P=0.045). A multivariate analysis revealed that surgery with neoadjuvant and adjuvant chemotherapy (hazard ratio: 0.374; 95% confidence interval: 0.173–0.808, P=0.012) was independently associated with overall survival.ConclusionsPatients with stage IIIA small cell lung cancer treated with surgical resection plus chemotherapy demonstrated longer overall survival compared with those who underwent concurrent chemo-radiotherapy. Surgery may be an option for clinical stage IIIA small cell lung cancer after induction chemotherapy in selected patients.
ISSN	20721439
Journal	Journal of Thoracic Disease
Volume Number	13
PubMed Central reference number	PMC8182514
Issue Number	5
PubMed reference number	34164166
e-ISSN	20776624
DOI	10.21037/jtd-20-3047
Language	English
Publisher	AME Publishing Company
Publisher Date	2021-05-01
Access Restriction	Open
Rights License	Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0. 2021 Journal of Thoracic Disease. All rights reserved.
Subject Keyword	Small cell lung cancer (SCLC) surgery chemotherapy
Content Type	Text
Resource Type	Article
Subject	Pulmonary and Respiratory Medicine