Efficacy evaluation of surgery combined with chemotherapy for stage IIIA small cell lung cancer patients: a retrospective analysis.

Content Provider	Europe PMC
Author	Bian, Dongliang Jiang, Siming Xiong, Yicheng Qi, Mengfan Wu, Jiawei Addeo, Alfredo Yamauchi, Yoshikane Manapov, Farkhad Dempke, Wolfram C. M. Vannucci, Jacopo Di Federico, Alessandro Xu, Xiaoxiong Chen, Linsong
Copyright Year	2022
Abstract	BackgroundThe efficacy of surgery in combination of chemotherapy for stage IIIA small cell lung cancer (IIIA-SCLC) is controversial. The aim of the present study was to analyze the efficacy of surgery combined with chemotherapy, especially in the setting of neoadjuvant chemotherapy (NAC) followed by surgery for IIIA-SCLC.MethodsBetween 2004 and 2015, we reviewed 2,199 chemotherapy-treated stage IIIA (N1/2) SCLC cases in the Surveillance, Epidemiology, and End Results (SEER) database, and 32 NAC + intentional radical resection-treated, centrally-located IIIA-SCLC cases at Shanghai Pulmonary Hospital (SPH). Outcomes were compared between surgically and non-surgically treated patients from the SEER database after propensity score matching (PSM), and comparing lobectomy/bi-lobectomy and pneumonectomy patients from SPH. Prognostic factors were evaluated by Kaplan-Meier method and the Cox proportional hazards regression model.ResultsThere was significantly higher overall survival (OS) in surgically treated IIIA-SCLC patients (OS, 44.8 vs. 21.2 months, P=0.048), and similar efficacy was observed between sub-lobectomy and lobectomy/bi-lobectomy patients (OS: 55.6 vs. 30.3 months, P=0.167) in SEER database. At SPH, significantly higher OS was associated with T1 stage (before NAC: T1 vs. T2–4, 48.7 vs. 32.2 months, P=0.025; after NAC: T1 vs. T2–4, 42.7 vs. 21.3 months, P=0.048). Female sex [hazard ratio (HR): 0.078, P=0.009], T1 stage (HR: 13.048, P=0.026), and pneumonectomy (HR: 0.095, P=0.009) were independent prognostic factors for IIIA-SCLC patients who received NAC + intentional radical resection.ConclusionsFor stage IIIA SCLC patients, complete resection combined with chemotherapy might improve the prognosis than patients without surgery. Post-NAC lobectomy was not found to be superior to sub-lobectomy, while pneumonectomy was considered suitable for central-type IIIA-SCLC patients after NAC treatment.
ISSN	22186751
Journal	Translational Lung Cancer Research
Volume Number	11
PubMed Central reference number	PMC9459616
Issue Number	8
PubMed reference number	36090643
e-ISSN	22264477
DOI	10.21037/tlcr-22-545
Language	English
Publisher	AME Publishing Company
Publisher Date	2022-08-01
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. 2022 Translational Lung Cancer Research. All rights reserved.
Subject Keyword	Small cell lung cancer (SCLC) limited disease neoadjuvant chemotherapy (NAC) surgery
Content Type	Text
Resource Type	Article
Subject	Oncology