Surgery ups survival in elders with early-stage SCLC

  • Li Y & al.
  • J Cancer Res Clin Oncol
  • 13 Jul 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Surgical resection for stage I small-cell lung cancer (SCLC) was associated with significantly longer OS and lung cancer-specific survival (LCSS) in elderly patients aged 75-84 years.

Why this matters

  • Less than one-quarter of patients aged ≥75 years underwent surgery, despite guidelines’ recommendations for resection in early-stage SCLC.

Study design

  • 983 patients aged ≥75 years with stage I SCLC from the Surveillance, Epidemiology, and End Results database.
  • Funding: Changzhou Science and Technology Bureau.

Key results

  • 24.0% underwent surgery, 46.6% nonsurgical treatment, and 29.4% had no treatment.
  • Younger patients in the study were more likely to undergo surgery than older patients (29.3% in ages 75-79 years; 19.1% in ages 80-84 years; and 16.4% in patients aged ≥85 years; P<.0001>
  • Surgery yielded significantly better 5-year OS (31% vs no surgery, 12% and no treatment, 6%; P<.0001 and lcss vs p>
  • In multivariate analysis, surgery predicted OS and LCSS benefit in patients aged:
    • 75-79 years (aHR, 0.506 and 0.449, both P<.0001>
    • 80-84 years (aHR, 0.544 [P<.0001 and>
  • Benefit failed to reach significance among patients aged ≥85 years.

Limitations

  • Retrospective study.