Dayen Charles, Debieuvre Didier, Molinier Olivier, Raffy Olivier, Paganin Fabrice, Virally Jérôme, Larive Sébastien, Desurmont-Salasc Béatrice, Perrichon Marielle, Martin Francis, Grivaux Michel
Respiratory Medicine Department, Hôpital de Saint-Quentin, Saint-Quentin, France.
Respiratory Medicine Department, Groupe Hospitalier de la Région Mulhouse Sud-Alsace, Hôpital Émile Muller, Mulhouse, France.
J Thorac Dis. 2017 Dec;9(12):5101-5111. doi: 10.21037/jtd.2017.11.52.
The French College of General Hospital Respiratory Physicians conducted two studies that consecutively included all patients followed in participating general hospitals for primary small cell (SCLC) or non-small cell (NSCLC) lung cancer diagnosed in 2000 and 2010. These studies allow descriptive statistics and outcome assessment for SCLC and NSCLC separately and comparison over a 10-year period.
A standardised form was completed for each patient at inclusion. Then, vital status was collected.
In 2000 and 2010, 948 (15.5% female) and 968 (23.3%) SCLC patients, mainly heavy active- or former-smoker seniors, participated in these studies. One-year survival rate was 35.8% for SCLC 44.8% for NSCLC in 2010 and 33.1% for SCLC in 2000. In 2010, in reference to stage 0-IIB (4.1% of SCLCs), the hazard ratio was 0.92 [95% confidence interval (CI): 0.6-1.5; P=0.76], 1.8 (95% CI: 1.1-2.8; P=0.019), and 3.4 (95% CI: 2.2-5.3; P<0.001) for stage IIIA (10.2%), IIIB (14.5%), and IV (71.2%). Positron emission tomography (PET)-scan use, which has increased in 10 years, was frequent in patients with limited disease.
One-year survival in SCLC patients was poor in 2010 and dependent of SCLC stage. TNM classification reintroduction and new diagnostic techniques (e.g., PET-scan) should allow lung oncologists to tailor treatment based on disease stage at diagnosis.
法国综合医院呼吸内科医师学会开展了两项研究，连续纳入了参与研究的综合医院中2000年和2010年诊断为原发性小细胞肺癌（SCLC）或非小细胞肺癌（NSCLC）的所有患者。这些研究分别对SCLC和NSCLC进行描述性统计和结局评估，并进行为期10年的比较。
纳入时为每位患者填写一份标准化表格。然后，收集生命状态信息。
2000年和2010年，分别有948例（女性占15.5%）和968例（女性占23.3%）SCLC患者参与了这些研究，这些患者主要是重度现吸烟者或既往吸烟者中的老年人。2010年SCLC患者的1年生存率为35.8%，NSCLC患者为44.8%，2000年SCLC患者的1年生存率为33.1%。2010年，参照0-IIB期（占SCLC的4.1%），IIIA期（占10.2%）、IIIB期（占14.5%）和IV期（占71.2%）的风险比分别为0.92[95%置信区间（CI）：0.6-1.5；P=0.76]、1.8（95%CI：1.1-2.8；P=0.019）和3.4（95%CI：2.2-5.3；P<0.001）。正电子发射断层扫描（PET）的使用在10年中有所增加，在疾病局限的患者中使用频繁。
2010年SCLC患者的1年生存率较低，且取决于SCLC分期。重新引入TNM分类和新的诊断技术（如PET扫描）应能使肺部肿瘤学家根据诊断时的疾病分期制定治疗方案。
