Surgery Plus Chemotherapy Versus Surgery Alone for Limited-Stage Small-Cell Lung Cancer: A Population-Based Survival Outcome Analysis
IntroductionFor patients with limited-stage small-cell lung cancer (LS-SCLC), effective treatment methods still remain a clinical challenge. The aim of this study is to evaluate the survival outcome of surgery plus chemotherapy vs. surgery alone in patients with LS-SCLC.MethodsLS-SCLC patients selec...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Frontiers Media S.A.
2021-05-01
|
Series: | Frontiers in Oncology |
Subjects: | |
Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.676598/full |
id |
doaj-230ff12e58bf40429b72fa97a2dc59d2 |
---|---|
record_format |
Article |
spelling |
doaj-230ff12e58bf40429b72fa97a2dc59d22021-05-17T05:43:16ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-05-011110.3389/fonc.2021.676598676598Surgery Plus Chemotherapy Versus Surgery Alone for Limited-Stage Small-Cell Lung Cancer: A Population-Based Survival Outcome AnalysisPingting Ye0Pingting Ye1Zhuolin Guo2Yanfei Zhang3Chunyan Dong4Ming Li5Department of Respiratory Medicine, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Oncology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Dermatology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Respiratory Medicine, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Oncology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Respiratory Medicine, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai, ChinaIntroductionFor patients with limited-stage small-cell lung cancer (LS-SCLC), effective treatment methods still remain a clinical challenge. The aim of this study is to evaluate the survival outcome of surgery plus chemotherapy vs. surgery alone in patients with LS-SCLC.MethodsLS-SCLC patients selected from the Surveillance, Epidemiology and End Results (SEER) database diagnosed between January 1, 2004, and December 31, 2015. Comparison of overall survival (OS) and cancer-specific survival (CSS) between two groups performed propensity score matching (PSM), inverse probability of treatment weight (IPTW), and overlap weighting analysis.ResultsOf the 477 LS-SCLC patients identified from the SEER database between 2004 and 2015, 262 (54.9%) received surgery-plus-chemotherapy treatment and the others received surgery-alone treatment. Univariate and multivariate analyses showed that treatment option (P< 0.001), tumor location (P= 0.02) and AJCC stage (P< 0.001) were independent prognostic predictors of OS in LS-SCLC patients. Median OS was 35 months in surgery-plus-chemotherapy group vs. 23 months in surgery-alone group. Survival analysis showed that surgery plus chemotherapy offered significantly improved OS as compared with surgery-alone treatment before and after IPTW, PSM and overlap weighting method (all P< 0.05). According to AJCC stage stratification, OS of the unmatched patients with stage I (P= 0.049) and II (P= 0.001) SCLC who received surgery-plus-chemotherapy treatment was significantly better than that of surgery-alone patients.ConclusionsThis cohort study showed that surgery plus chemotherapy was associated with longer survival time than surgery alone in LS-SCLC patients, especially in those with stage I and II SCLC. Further prospective studies are required to confirm our conclusions.https://www.frontiersin.org/articles/10.3389/fonc.2021.676598/fullsmall-cell lung cancersurgerychemotherapyoverall survivalSurveillanceEpidemiology and End Results (SEER) |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Pingting Ye Pingting Ye Zhuolin Guo Yanfei Zhang Chunyan Dong Ming Li |
spellingShingle |
Pingting Ye Pingting Ye Zhuolin Guo Yanfei Zhang Chunyan Dong Ming Li Surgery Plus Chemotherapy Versus Surgery Alone for Limited-Stage Small-Cell Lung Cancer: A Population-Based Survival Outcome Analysis Frontiers in Oncology small-cell lung cancer surgery chemotherapy overall survival Surveillance Epidemiology and End Results (SEER) |
author_facet |
Pingting Ye Pingting Ye Zhuolin Guo Yanfei Zhang Chunyan Dong Ming Li |
author_sort |
Pingting Ye |
title |
Surgery Plus Chemotherapy Versus Surgery Alone for Limited-Stage Small-Cell Lung Cancer: A Population-Based Survival Outcome Analysis |
title_short |
Surgery Plus Chemotherapy Versus Surgery Alone for Limited-Stage Small-Cell Lung Cancer: A Population-Based Survival Outcome Analysis |
title_full |
Surgery Plus Chemotherapy Versus Surgery Alone for Limited-Stage Small-Cell Lung Cancer: A Population-Based Survival Outcome Analysis |
title_fullStr |
Surgery Plus Chemotherapy Versus Surgery Alone for Limited-Stage Small-Cell Lung Cancer: A Population-Based Survival Outcome Analysis |
title_full_unstemmed |
Surgery Plus Chemotherapy Versus Surgery Alone for Limited-Stage Small-Cell Lung Cancer: A Population-Based Survival Outcome Analysis |
title_sort |
surgery plus chemotherapy versus surgery alone for limited-stage small-cell lung cancer: a population-based survival outcome analysis |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2021-05-01 |
description |
IntroductionFor patients with limited-stage small-cell lung cancer (LS-SCLC), effective treatment methods still remain a clinical challenge. The aim of this study is to evaluate the survival outcome of surgery plus chemotherapy vs. surgery alone in patients with LS-SCLC.MethodsLS-SCLC patients selected from the Surveillance, Epidemiology and End Results (SEER) database diagnosed between January 1, 2004, and December 31, 2015. Comparison of overall survival (OS) and cancer-specific survival (CSS) between two groups performed propensity score matching (PSM), inverse probability of treatment weight (IPTW), and overlap weighting analysis.ResultsOf the 477 LS-SCLC patients identified from the SEER database between 2004 and 2015, 262 (54.9%) received surgery-plus-chemotherapy treatment and the others received surgery-alone treatment. Univariate and multivariate analyses showed that treatment option (P< 0.001), tumor location (P= 0.02) and AJCC stage (P< 0.001) were independent prognostic predictors of OS in LS-SCLC patients. Median OS was 35 months in surgery-plus-chemotherapy group vs. 23 months in surgery-alone group. Survival analysis showed that surgery plus chemotherapy offered significantly improved OS as compared with surgery-alone treatment before and after IPTW, PSM and overlap weighting method (all P< 0.05). According to AJCC stage stratification, OS of the unmatched patients with stage I (P= 0.049) and II (P= 0.001) SCLC who received surgery-plus-chemotherapy treatment was significantly better than that of surgery-alone patients.ConclusionsThis cohort study showed that surgery plus chemotherapy was associated with longer survival time than surgery alone in LS-SCLC patients, especially in those with stage I and II SCLC. Further prospective studies are required to confirm our conclusions. |
topic |
small-cell lung cancer surgery chemotherapy overall survival Surveillance Epidemiology and End Results (SEER) |
url |
https://www.frontiersin.org/articles/10.3389/fonc.2021.676598/full |
work_keys_str_mv |
AT pingtingye surgerypluschemotherapyversussurgeryaloneforlimitedstagesmallcelllungcancerapopulationbasedsurvivaloutcomeanalysis AT pingtingye surgerypluschemotherapyversussurgeryaloneforlimitedstagesmallcelllungcancerapopulationbasedsurvivaloutcomeanalysis AT zhuolinguo surgerypluschemotherapyversussurgeryaloneforlimitedstagesmallcelllungcancerapopulationbasedsurvivaloutcomeanalysis AT yanfeizhang surgerypluschemotherapyversussurgeryaloneforlimitedstagesmallcelllungcancerapopulationbasedsurvivaloutcomeanalysis AT chunyandong surgerypluschemotherapyversussurgeryaloneforlimitedstagesmallcelllungcancerapopulationbasedsurvivaloutcomeanalysis AT mingli surgerypluschemotherapyversussurgeryaloneforlimitedstagesmallcelllungcancerapopulationbasedsurvivaloutcomeanalysis |
_version_ |
1721438625564983296 |