Division of Oncology, Washington University in St Louis School of Medicine, St Louis, Missouri, USA.
Departments of Medicine and Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Cancer. 2024 Jul 15;130(14):2453-2461. doi: 10.1002/cncr.35281. Epub 2024 Mar 12.
Small-cell lung cancer (SCLC) is characterized by rapid proliferation and early dissemination. The objective of this study was to examine the demographic trends and outcomes in SCLC.
The authors queried the National Cancer Institute's Surveillance, Epidemiology, and End Results database to assess the trends in incidence, demographics, staging, and survival for SCLC from 1975 to 2019. Trends were determined using joinpoint analysis according to the year of diagnosis.
Among the 530,198 patients with lung cancer, there were 73,362 (13.8%) with SCLC. The incidence per 100,000 population peaked at 15.3 in 1986 followed by a decline to 6.5 in 2019. The percentage of SCLC among all lung tumors increased from 13.3% in 1975 to a peak of 17.5% in 1986, declining to 11.1% by 2019. There was an increased median age at diagnosis from 63 to 69 years and an increased percentage of women from 31.4% to 51.2%. The percentage of stage IV increased from 58.6% in 1988 to 70.8% in 2010, without further increase. The most common sites of metastasis at diagnosis were mediastinal lymph nodes (75.3%) liver (31.6%), bone (23.7%), and brain (16.4%). The 1-year and 5-year overall survival rate increased from 23% and 3.6%, respectively, in 1975-1979 to 30.8% and 6.8%, respectively, in 2010-2019.
The incidence of SCLC peaked in 1988 followed by a gradual decline. Other notable changes include increased median age at diagnosis, the percentage of women, and the percentage of stage IV at diagnosis. The improvement in 5-year overall survival has been statistically significant but clinically modest.
小细胞肺癌（SCLC）的特点是快速增殖和早期扩散。本研究旨在研究 SCLC 的人口统计学趋势和结果。
作者通过查询美国国家癌症研究所的监测、流行病学和最终结果数据库，评估了 1975 年至 2019 年 SCLC 的发病率、人口统计学、分期和生存趋势。趋势根据诊断年份使用连接点分析确定。
在 530198 例肺癌患者中，有 73362 例（13.8%）为 SCLC。每 10 万人中的发病率在 1986 年达到 15.3 的峰值，随后下降到 2019 年的 6.5。SCLC 在所有肺癌肿瘤中的比例从 1975 年的 13.3%上升到 1986 年的 17.5%的峰值，到 2019 年下降到 11.1%。诊断时的中位年龄从 63 岁增加到 69 岁，女性比例从 31.4%增加到 51.2%。IV 期的比例从 1988 年的 58.6%增加到 2010 年的 70.8%，没有进一步增加。诊断时最常见的转移部位是纵隔淋巴结（75.3%）、肝脏（31.6%）、骨骼（23.7%）和大脑（16.4%）。1 年和 5 年总生存率分别从 1975-1979 年的 23%和 3.6%上升到 2010-2019 年的 30.8%和 6.8%。
SCLC 的发病率在 1988 年达到峰值，随后逐渐下降。其他值得注意的变化包括诊断时的中位年龄增加、女性比例增加和 IV 期比例增加。5 年总生存率的提高在统计学上有意义，但在临床上意义不大。
