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Hideo Ichimura

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    P1.12 - Small Cell Lung Cancer/NET (Not CME Accredited Session) (ID 944)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.12-14 - Survival of Patients with Small-Cell Lung Cancer Undergoing Surgical Resection (ID 13768)

      16:45 - 18:00  |  Author(s): Hideo Ichimura

      • Abstract


      Small-cell lung cancer (SCLC) prognosis remains poor despite improvements in diagnosis and therapy. Current standard treatment for limited stage SCLC is concurrent chemo-radiotherapy, however recent retrospective studies indicate that surgery is an important treatment modality. We analyzed the overall survival and prognostic predictors of survival in patients who underwent surgical resection.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We reviewed the clinical course of 42 SCLC patients who had undergone complete surgical resection in our hospital between May 1989 and October 2017. Stages were determined or reclassified according to the eighth version of the TNM staging system.

      4c3880bb027f159e801041b1021e88e8 Result

      The mean age at pulmonary surgery was 68.0 years, 37 (88.1%) patients were male, and 2 (4.8%) were never smokers. Preoperative diagnosis of cancer was achieved in 18 (42.9%) patients. The surgical procedures included wedge resection in 6 (14.3%) and lobectomy in 36 (85.7%). There were no perioperative deaths and major postoperative complications. Thirty-two patients (76.2%) received adjuvant chemotherapy and three patients (7.1%) underwent prophylactic cranial irradiation. Pathological stages were 2 cases in IA1, 5 in IA2, 1 in IA3, 6 in IB, 3 in IIA, 8 in IIB, 13 in IIIA, 3 in IIIB, 1 in IVA. The pathology of primary tumor demonstrated 30 (71.4%) pure SCLC and 12 (28.6%) combined SCLC. The overall 5-year survival rate was 57.2% after an average follow-up of 58.7 months. A significantly good survival was observed using univariate analysis in patients with female (p=0.048), preoperative normal serum level of CEA (p=0.013), normal serum level of SCC (p<0.001), pR0 resection (p=0.02), adjuvant chemotherapy (p<0.001), and histological pure SCLC (p=0.002). In preoperative factor, multivariate Cox proportional hazard model analysis revealed that overall survival was shorter in patients with increased SCC levels and cN1or 2.

      8eea62084ca7e541d918e823422bd82e Conclusion

      We conclude that pulmonary resection for early-stage SCLC is a safe and effective treatment strategy, and adjuvant chemotherapy may be useful in patients undergoing surgery in a practical management. Increased SCC levels and cN1 or 2 were identified as prognosis-related criteria for a poor prognosis of resected early SCLC.