Details

Autor(en) / Beteiligte

• Zhou, Nicolas
• Bott, Matthew
• Park, Bernard J.
• Vallières, Eric
• Wilshire, Candice L.
• Yasufuku, Kazuhiro
• Spicer, Jonathan D.
• Jones, David R.
• Sepesi, Boris
• Mitchell, Kyle G.
• Corsini, Erin M.
• Antonoff, Mara B.
• Hofstetter, Wayne L.
• Mehran, Reza J.
• Rice, David C.
• Swisher, Stephen G.
• Vaporciyan, Ara A.
• Walsh, Garrett L.
• Huynh, Caroline
• Fiset, Pierre-Olivier
• Chun, Stephen G.
• Gay, Carl M.

Titel

Predictors of survival following surgical resection of limited-stage small cell lung cancer

Ist Teil von

• The Journal of thoracic and cardiovascular surgery, 2021-03, Vol.161 (3), p.760-771.e2

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• Adjuvant chemotherapy, postoperative radiation (PORT), and prophylactic cranial irradiation (PCI) have been individually examined in limited-stage small cell lung cancer (SCLC). There is a paucity of data on the effectiveness of each adjuvant treatment modality when used in combination after surgical resection of SCLC. Data were collected from 5 cancer centers on all patients with limited-stage SCLC who underwent surgical resection between 1986 and 2019. Univariate and multivariable models were conducted to identify predictors of long-term outcomes, focusing on freedom from recurrence and survival benefit of adjuvant chemotherapy, PORT, and PCI. A total of 164 patients were analyzed. Multivariable Cox regression analysis did not identify any adjuvant therapies to significantly influence recurrence in this cohort. Specifically, PORT was not associated with a significant influence on locoregional recurrence and PCI was not significantly associated with intracranial outcomes. Adjuvant chemotherapy improved survival in all stage I through III disease (hazard ratio, 0.49; 95% confidence interval, 0.29-0.81; P = .005) and even in pathologically node negative patients (hazard ratio, 0.49; 95% confidence interval, 0.27-0.91; P = .024). Although PCI was found to improve survival in univariate analysis, it was not significant in a multivariable model. PORT was not found to affect survival on either univariate or multivariable analysis. This is among the largest multi-institutional studies on surgically resected limited-stage SCLC. Our results highlight survival benefit of adjuvant chemotherapy, but did not identify a statistically significant influence from mediastinal PORT or PCI in our cohort. Larger prospective studies are needed to determine the benefit of PORT or PCI in a surgically resected limited-stage SCLC population. [Display omitted]