AUTHOR=Ning Jing , Ge Tao , Zhu Shuncang , Han Yingli , Ruan Suhong , Ma Yuchen , Liu Rentao 

TITLE=The role of surgery in older patients with T1-2N0M0 small cell lung cancer: A propensity score matching analysis

JOURNAL=Frontiers in Oncology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.958187

DOI=10.3389/fonc.2022.958187

ISSN=2234-943X

ABSTRACT=Background: Surgical resection could improve the survival of early-stage small cell lung cancer (SCLC) patients. However, there lacked of dedicated studies concentrating on surgical treatment in older patients with T1-2N0M0 SCLC. So we performed this population-based study to investigate whether older patients with T1-2N0M0 SCLC benefit from surgery. 
Methods: We collected the data of patients with SCLC between 2000 and 2015 from the Surveillance Epidemiology and End Results (SEER) database. Older patients (≥ 65 years) with T1-2N0M0 SCLC were included and we converted the staging information into those of the 8th edition. The propensity score matching (PSM) was used to balance the distribution of clinical characteristics between surgery and no surgery groups. 
Results: After 1:2 PSM, the distribution proportions of clinical characteristics in 683 patients were balanced (all P> 0.05). The OS and CSS of patients in the surgery group were better than patients in the no surgery group (all P< 0.001) and subgroup analysis showed that the surgery was a protective factor for OS and CSS in all clinical characteristics subgroups. The result of subgroup analysis based on age, T stage, and treatment showed that surgery was related to better OS and CSS and lobectomy exhibited the longer survival than sublobectomy. Age, sex and race was the independent prognostic factor for OS in patients undergoing surgery while only the factor of age affect the CSS in patients with surgery.
Conclusions: Older patients with T1-2N0M0 SCLC can benefit significantly from surgical treatment and lobectomy provides better prognosis than sublobectomy.