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The Role of Thoracic Surgery in Small Cell Lung Cancer – A Large Longitudinal Analysis (2002-2015) Based on Real-World Data

医学 楔形切除术 队列 全肺切除术 外科 肺癌 疾病 化疗 切除术 肿瘤科 内科学
作者
Diego Kauffmann‐Guerrero,Julia Walter,Julia Kovács,Laura Sellmer,Rudolf Hatz,Jürgen Behr,G. Schubert-Fritschle,Amanda Tufman,Christian Schneider
出处
期刊:Clinical Lung Cancer [Elsevier]
卷期号:23 (3): 244-252 被引量:5
标识
DOI:10.1016/j.cllc.2022.01.004
摘要

Most SCLC patients are diagnosed with extensive disease (ED) and the prognosis in this cohort remains poor. However, some patients are diagnosed with limited (LD) or very limited (VLD, T1-2, N0-1, M0) disease and previous data suggest that surgical resection might improve outcomes in these patients. Most of the existing evidence comes from small case series. For this reason, we investigated clinical features and surgical outcomes in a large cohort of resected SCLC patients.We used a large pseudomized dataset (n = 32432) provided by the Munich Cancer Registry to analyze all documented SCLC patients (n = 5043) between 2002 and 2015. We correlated patients' characteristics as well as surgery modalities with survival data and describe trends in the role of surgery in SCLC over the time.We analyzed 5043 SCLC patients. A total of 161 (3.2%) received either oncological (lobectomy, bilobectomy and pneumonectomy) or limited resection (segmentectomy and wedge resection). We found a significant trend suggesting that resections in SCLC patients become less common in all stages of disease, accompanied by an increased proportion of oncological resections. This suggests a more accurate preoperative staging. In VLD resection was significantly associated with longer survival compared to nonsurgical management (log-rank P = .013). Survival was better with oncological resection compared to atypical resection. Administration of adjuvant chemotherapy was associated with better outcome in all resected patients (P = .01).VLD SCLC patients benefit from oncological resection. We recommend invasive staging in these patients to ensure VLD. Furthermore, adjuvant chemotherapy should be offered to all resected patients.
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