Original Research ARTICLE
Prognostic analysis of limited resection versus lobectomy in stage IA small cell lung cancer patients based on the Surveillance, Epidemiology and End Results registry database
- 1Department of Thoracic Surgery, Shanghai Pulmonary Hospital, China
- 2Department of Anorectal surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, China
- 3Shanghai Chest Hospital, Shanghai Jiaotong University, China
Objective: The prognostic analysis of limited resection versus lobectomy in stage IA small cell lung cancer (SCLC) remains scarce.
Methods: Using the Surveillance, Epidemiology and End Results registry (SEER) database, we identified patients who were diagnosed with pathological stage IA (T1a/bN0M0) SCLC from 2004 to 2013. The overall survival (OS) and lung cancer-specific survival (LCSS) rates of patients with different treatment schemes were compared in stratification analyses. Univariable and multivariable analyses were also performed to identify the significant predictors of OS and LCSS.
Results: In total, we extracted 491 pathological stage IA SCLC patients, 106 (21.6%) of whom received lobectomy, 70 (14.3%) received sublobar resection and 315 (64.1%) received non-surgical treatment, respectively. There were significant differences among the groups based on different treatment schemes in OS (log-rank p <0.0001) and LCSS (log-rank p <0.0001). Furthermore, in subgroup analyses, we did not identify any differences between sublober resection group and lobectomy group in OS (log-rank p =0.14) or LCSS (log-rank p =0.4565). Patients with 4 or more lymph node dissection had better prognosis. Multivariable analyses revealed age, laterality, tumor location and N number were still significant predictors of OS, whereas age, tumor location and N number were significant predictors of LCSS.
Conclusions: Surgery is an important component of multidisciplinary treatment for stage IA SCLC patients and sublober resection is not inferior to lobectomy for the specific patients.
Keywords: Small Cell Lung Cancer, prognosis, sublober resection, Lobectomy, lung cancer
Received: 06 Oct 2018;
Accepted: 06 Nov 2018.
Edited by:Tao Huang, Shanghai Institutes for Biological Sciences (CAS), China
Reviewed by:FEN XUE, Fudan University Shanghai Cancer Center, China
Jun Y. Qian, West China Hospital, Sichuan University, China
Copyright: © 2018 Gu, Huang, Dai, Wang, Ren, She, Su and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Prof. Chang Chen, Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Yangpu, China, email@example.com