en
Scientific article
Open access
English

Adjuvant treatment for patients with incidentally resected limited disease small cell lung cancer-a retrospective study

Published inTranslational lung cancer research, vol. 11, no. 9, p. 1951-1960
Publication date2022-09
Abstract

Background: With the exception of very early-stage small cell lung cancer (SCLC), surgery is not typically recommended for this disease; however, incidental resection still occurs. After incidental resection, adjuvant salvage therapy is widely offered, but the evidence supporting its use is limited. This study aimed to explore proper adjuvant therapy for these incidentally resected SCLC cases.

Methods: Patients incidentally diagnosed with SCLC after surgery at the Shanghai Pulmonary Hospital in China from January 2005 to December 2014 were included in this study. The primary outcome was overall survival. Patients were classified into different group according to the type of adjuvant therapy they received and stratified by their pathological lymph node status. Patients' survival was analyzed using a Kaplan-Meier analysis and Cox regression analysis.

Results: A total of 161 patients were included in this study. Overall 5-year survival rate was 36.5%. For pathological N0 (pN0) cases (n=70), multivariable analysis revealed that adjuvant chemotherapy (ad-chemo) was associated with reduced risk of death [hazard ratio (HR): 0.373; 95% confidence interval (CI): 0.141-0.985, P=0.047] compared to omission of adjuvant therapy. For pathological N1 or N2 (pN1/2) cases (n=91), taking no adjuvant therapy cases as a reference, the multivariable analysis showed that ad-chemo was not associated with a lower risk of death (HR: 0.869; 95% CI: 0.459-1.645, P=0.666), while adjuvant chemo-radiotherapy (ad-CRT) was associated with a lower risk of death (HR: 0.279; 95% CI: 0.102-0.761, P=0.013).

Conclusions: Patients who incidentally receive surgical resection and are diagnosed with limited disease SCLC after resection should be offered adjuvant therapy as a salvage treatment. For incidentally resected pN0 cases, ad-chemo should be considered and for pN1/2 cases, ad-CRT should be received.

eng
Keywords
  • Small cell lung cancer (SCLC)
  • Adjuvant therapy
  • Surgery
Citation (ISO format)
JIN, Kai-Qi et al. Adjuvant treatment for patients with incidentally resected limited disease small cell lung cancer-a retrospective study. In: Translational lung cancer research, 2022, vol. 11, n° 9, p. 1951–1960. doi: 10.21037/tlcr-22-616
Main files (1)
Article (Published version)
Secondary files (3)
Identifiers
ISSN of the journal2218-6751
14views
4downloads

Technical informations

Creation07/31/2023 12:35:55 PM
First validation10/05/2023 9:22:14 AM
Update time10/05/2023 9:22:14 AM
Status update10/05/2023 9:22:14 AM
Last indexation01/18/2024 1:05:03 AM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack