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Small-cell lung cancer resection with chemotherapy improves survival

Patients who underwent resection alone for T1-2N0M0 small-cell lung cancer had worse outcomes compared with patients who underwent adjuvant chemotherapy and prophylactic cranial irradiation, according to recent research.

“The findings of this [National Cancer Data Base] analysis suggest that patients with pathologic stage T1-2N0M0 [small-cell lung cancer (SCLC)] can benefit from both adjuvant chemotherapy and chemotherapy with [prophylactic cranial irradiation] after surgery,” Chi-Fu Jeffrey Yang, MD, of Duke University Medical Center, and colleagues wrote. “Given the limitations of this study noted earlier, these findings should be evaluated further in randomized controlled trials.”

Yang and colleagues evaluated 1,574 patients from the National Cancer Data Base who underwent resection for T1-2N0M0 SCLC between 2003 and 2011, according to the abstract. Sixty-one percent (n = 954) underwent complete resection, and 59% (n = 566) received adjuvant therapy that consisted of chemotherapy (n = 354), chemoradiation (n = 190) or radiation (n = 22).

The researchers observed a 47% 5-year overall survival rate for patients who underwent resection. Survival rates improved further with adjuvant therapy (HR = 0.78; 95% CI, 0.63-0.95) or prophylactic cranial irradiation (HR = 0.52; 95% CI, 0.360.75 vs. surgery alone, according to the abstract. – by Jeff Craven

Disclosure: Yang reports support from the American College of Surgeons Resident Research Scholarship. Two other researchers report support from the National Institutes of Health Cardiothoracic Surgical Trials Network. Please see the full study for a complete list of all other researchers’ relevant financial disclosures.