Survival of patients with small cell lung carcinoma in Taiwan.

BACKGROUND

Small cell lung cancer (SCLC) is the most aggressive form of lung cancer. The prognosis for SCLC patients remains unsatisfactory despite advances in chemotherapy. In this study, we sought to clarify the prognosis and treatment patterns of patients with SCLC.

METHODS

A cohort comprising all patients diagnosed with SCLC between January 2004 and December 2006 was assembled from the Taiwan Cancer Database. Patients were followed up until December 31, 2009, to determine overall survival. Patient survival was estimated using the Kaplan-Meier method, and Cox's proportional hazard model was used to determine the relationship between prognostic factors and median survival time.

RESULTS

Among the 1,684 patients diagnosed with SCLC, 1,215 (72%) were diagnosed with extensive-stage disease and 469 (28%) with limited-stage disease. Most of the patients were male (90%). The median survival duration of patients with limited-stage and extensive-stage SCLC was 10.3 months and 5.6 months, respectively. For limited-stage patients, surgery, chemotherapy, and combined chemotherapy and radiotherapy resulted in better survival than best supportive care (HR 0.20, p < 0.001; HR 0.61, p < 0.001, and HR 0.37, p < 0.001, respectively). For extensive-stage patients, male gender was significantly associated with a poor prognosis (HR 1.45, p < 0.001) and chemotherapy was shown to improve overall survival more effectively than best supportive care (HR 0.37, p < 0.001).

CONCLUSION

For limited-stage SCLC patients, surgery, chemotherapy, and combined chemotherapy and radiotherapy improved survival compared to best supportive care. Extensive-stage SCLC patients benefited more from chemotherapy treatment than from best supportive care.