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Prognostic significance of the 8th edition of the TNM classification for patients with extensive disease small cell lung cancer

BACKGROUND: Small cell lung cancer (SCLC) is typically categorized according to disease extent as limited or extensive, and utility of the 8th TNM classification, recommended for lung cancer staging, which demonstrates a strong association with non-small-cell lung cancer (NSCLC) management, remains...

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Detalles Bibliográficos
Autores principales: Shirasawa, Masayuki, Fukui, Tomoya, Kusuhara, Seiichiro, Hiyoshi, Yasuhiro, Ishihara, Mikiko, Kasajima, Masashi, Nakahara, Yoshiro, Otani, Sakiko, Igawa, Satoshi, Yokoba, Masanori, Mitsufuji, Hisashi, Kubota, Masaru, Katagiri, Masato, Sasaki, Jiichiro, Naoki, Katsuhiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252783/
https://www.ncbi.nlm.nih.gov/pubmed/30538553
http://dx.doi.org/10.2147/CMAR.S181789
Descripción
Sumario:BACKGROUND: Small cell lung cancer (SCLC) is typically categorized according to disease extent as limited or extensive, and utility of the 8th TNM classification, recommended for lung cancer staging, which demonstrates a strong association with non-small-cell lung cancer (NSCLC) management, remains unclear. METHODS: This retrospective study included 277 consecutive SCLC patients treated at a single institution between 2008 and 2016. RESULTS: According to the currently used two-stage system, 186 (65.7%) of the patients were classified as having extensive disease (ED)-SCLC. Among the ED-SCLC patients, ten (5.3%), 38 (20.4%), 32 (17.2%), and 106 (57.0%) were categorized into stages M0, M1a, M1b, and M1c, respectively, according to the 8th TNM classification. There was a significant difference in overall survival based on the M descriptors: 15.8 (95% CI 9.4–22.2) months in the M1b group vs 7.3 (95% CI 5.7–8.9) months in the M1c group (P<0.001). Multivariate analysis showed that in addition to the known prognostic factors such as performance status, serum albumin, and lactate dehydrogenase, M descriptor was a prognostic factor (HR 1.95, 95% CI 1.38–2.77; P<0.001). CONCLUSION: The 8th TNM classification has a prognostic value in SCLC. Similarly to NSCLC, treatment approaches should be considered on the basis of the 8th TNM classification, especially stage IVA separate from stage IVB in ED-SCLC patients.