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Objective:To investigate the prognostic factors and survival of patients with combined small cell lung cancer (C-SCLC) after they underwent complete resection. Methods:The clinical records of C-SCLC patients who were subjected to complete resection and systematic nodal dissection in one institution between January 2010 and December 2014 were retrospectively reviewed. Results:Sev-enty-eight patients with histologically diagnosed C-SCLC were identified. The most common combined component was large cell neuro-endocrine carcinoma (LCNEC) (n=42), followed by squamous cell carcinoma (SCC) (n=18), adenocarcinoma (AC) (n=10), and adenosqua-mous carcinoma (ASC) (n=8). The overall survival (OS) rate of the entire cohort was 39.1%. Multivariate analyses using Cox's propor-tional hazard models revealed that size [3 cm;hazard ratio (HR)=0.406;95%confidence interval (CI)=0.202-0.816;P=0.011], performance status (2;HR=0.113;95%CI=0.202-0.631;P=0.013), combined non-small cell lung cancer (NSCLC) components (LCNEC vs. non-LCNEC, HR=3.00;95%CI=0.096-0.483;P<0.001), stage Ⅲ A vs.Ⅰ;HR=0.195, 95%CI:0.063-0.602;P=0.004) and adju-vant therapy (yes vs. no, HR=0.402;95%CI=0.195-0.831;P=0.014) were significant prognostic factors of OS. Conclusion:The mixed NSCLC components within C-SCLC significantly influence survival. Adjuvant therapy is beneficial for patients with complete resection of C-SCLC.
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Objective To investigate the impact of surgical resection on patients with Ⅱ-Ⅲ A stage small cell lung carcinoma (SCLC). Method Data of 61 in-patients who diagnosed as Ⅱ-ⅢA stage SCLC from Jan 1st 2009 to Feb 1st 2014 were analyzed. 23 patients underwent surgical resections were enrolled as the treatment group, while 38 patients without surgical resection were enrolled as the control group. Disease progression was confirmed by monthly examination. The grouping is balanced by propensity score match. The progression-free survival (PFS) time and overall survival(OS) were analyzed with Kaplan-Meier survival method and Cox regression is applied to analyze the covariates. Fisher's exact test was applied to compare one-year survival rate and two-year survival rate. Results The PFS and OS of the treatment group is longer than that of the control group (P < 0.05). Both one-year and two-year survival rates of the treatment group outnumber those of the control group (P < 0.05). Cox regression indicates that surgical resection is an independent prognostic factor (P < 0.05). Conclusion Surgical resection on tolerable patients with stage Ⅱ-Ⅲ A small-cell lung carcinoma is effective on improving the progression-free survival time,one-year and two-year survival rates,and also shows a propensity of a higher overall survival time.
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Objective:To compare the therapeutic and adverse effects of chemotherapeutic regimen based on three drugs (taxol+carboplatin/cisplatin+etoposide) and two drugs (carboplatin/cisplatin+etoposide) on the combined small cell lung cancer (CSCLC). Methods:A retrospective study was conducted based on the data of 62 CSCLC patients who were admitted to and treated at Tianjin Medical University Cancer Institute and Hospital between July 2000 and April 2013. Of the 62 patients, 19 received the three-drug regi-men and 43 received the two-drug regimen. All patients received at least two cycles of chemotherapy and completed follow-up proce-dures. For each patient, the therapeutic efficacy was evaluated every two cycles, and toxicity was evaluated every cycle. Results:The response rates between the three-drug and two-drug groups were statistically significant (90%vs. 53%, P=0.033). However, no statisti-cal differences were observed in the disease control rate between the two groups (100% vs. 86%, P=0.212). The three-drug regimen could induce a better median progression-free survival compared with the two-drug regimen, but with no statistical significance (10.5%vs. 9.8%, P=0.484). Similarly, no statistical differences were noted in the median overall survival between the three-drug and two-drug groups (24.0%vs. 17.5%, P=0.457). The incidence rates of grade IV bone marrow depression and the termination of the original regi-men owing to severe adverse reactions were both significantly higher in the three-drug group than in the two-drug group (26.3% vs. 7.0%, P=0.036;31.6%vs. 14.7%, P=0.004). Conclusion:The two-drug regimen had almost the same survival rate and lower toxicity compared with the three-drug regimen. When using the TEP/TCE regimen, a close attention should be focused on its adverse reactions. The findings of this work showed that the two-agent regimen should be one of the standard treatments for CSCLC.
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Objective:This study aimed to analyze and compare the prognosis and the prognostic factors of combined small cell lung cancer (CSCLC) and pure small cell lung cancer (PSCLC) retrospectively. Methods:The clinicopathological characteristics of the 343 small cell lung cancer patients who were diagnosed in Tianjin Medical University Cancer Institute and Hospital between January 2006 and December 2012 were collected and reviewed. Survival analysis was performed and prognostic factors were assessed. Results:The median OS (overall survival) and PFS (progression free survival) of CSCLC were 31 and 21 months, respectively, and the median OS and PFS of PSCLC were 15 and 9 months, respectively. The Kaplan-Meier survival curves revealed that the prognosis of CSCLC was significantly better compared with that of PSCLC. COX analysis showed that disease stage, pathology, and therapy were indepen-dent prognostic factors of small cell lung cancer. Univariate analysis indicated that the small cell lung cancer group benefited from the surgery, particularly the CSCLC. NLR , therapy, and disease stage influenced the prognosis of PSCLC, and disease stage and therapy in-fluenced the prognosis of CSCLC. Multivariate analysis revealed that disease stage and therapy were independent risk factors of CSCLC in regard to OS. Conclusion:The prognosis of CSCLC was better compared with that of PSCLC. Limited-stage small cell lung cancer should undergo surgery, particularly the CSCLC.
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Appropriate pathologic diagnosis of small cell lung cancer (SCLC) is essential in order to apply the aggressive treatment modalities. But several subtypes of SCLC were suggested by various authors based on morphological features. Among them, the incidence of small cell lung cancer (SCLC) combined with squamous cell and/or adenocarcinoma, combined small cell lung cancer, represent less than 1% to 3% of SCLC tumors. Because of the rarity of SCLC combined with squamous cell and/or adenocarcinoma, very little is known about the clinical characteristics and response to therapy of these tumor. We report a case of SCLC combined with squamous cell and adenocarcinoma in 68 year old male who experienced pneumonectomy of the left lung.