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Clinicopathological Difference and Survival Impact of Patients with c-SCLC and SCLC
BACKGROUND: Combined small cell lung cancer (c-SCLC) distinguishes itself from small cell lung cancer (SCLC) due to its inclusion of both SCLC and non-small cell lung cancer (NSCLC) components. Few studies have compared clinicopathological characteristics, prognosis and factors affecting survival. W...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8536838/ https://www.ncbi.nlm.nih.gov/pubmed/34703294 http://dx.doi.org/10.2147/IJGM.S332725 |
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author | Zhang, Chenyue Shang, Xiaoling Sun, Jian Li, Zhenxiang Lin, Jiamao Zhao, Chenglong Wang, Haiyong |
author_facet | Zhang, Chenyue Shang, Xiaoling Sun, Jian Li, Zhenxiang Lin, Jiamao Zhao, Chenglong Wang, Haiyong |
author_sort | Zhang, Chenyue |
collection | PubMed |
description | BACKGROUND: Combined small cell lung cancer (c-SCLC) distinguishes itself from small cell lung cancer (SCLC) due to its inclusion of both SCLC and non-small cell lung cancer (NSCLC) components. Few studies have compared clinicopathological characteristics, prognosis and factors affecting survival. We therefore addressed the issues in this study. PATIENTS AND METHODS: A total of 400 c-SCLC and 20,841 SCLC patients were enrolled using SEER database. Difference in clinicopathological characteristics of SCLC and c-SCLC patients was analyzed using chi-square. Kaplan–Meier was applied to compare their survival before and after propensity score matching (PSM). Cox regression model was adopted to assess the impact of different clinical variables on survival. Logistic regression was applied to identify risk factors for c-SCLC and SCLC patients. RESULTS: Differences in race, sex, T stage, N stage, surgery, bone, brain and liver metastasis were detected between c-SCLC and SCLC patients. c-SCLC patients had better overall survival (OS) than SCLC patients before PSM. Age, race, sex, T stage, N stage, surgery, bone, brain, liver and lung metastasis were prognostic factors affecting OS for c-SCLC and SCLC (P < 0.05). However, a significant OS benefit was not observed in c-SCLC after adjusting for clinicopathological variables (HR, 0.950; 95% CI, 0.842–1.073; P=0.411). No significant OS difference was found between c-SCLC and SCLC patients after PSM (P = 0.789). c-SCLC patients had lower risk of lymph node (OR: 0.555; 95% CI: 0.439–0.703; P < 0.001) and liver metastasis (OR: 0.591; 95% CI: 0.448–0.779; P < 0.001), whereas had no significant differences in bone and brain metastasis risks (P > 0.05) compared with SCLC patients. CONCLUSION: The prognosis of c-SCLC did not significantly differ from that of SCLC if clinicopathological characteristics are controlled. Better prognosis for c-SCLC patients over SCLC patients may be ascribed to fewer liver and lymph node metastases upon diagnosis. |
format | Online Article Text |
id | pubmed-8536838 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-85368382021-10-25 Clinicopathological Difference and Survival Impact of Patients with c-SCLC and SCLC Zhang, Chenyue Shang, Xiaoling Sun, Jian Li, Zhenxiang Lin, Jiamao Zhao, Chenglong Wang, Haiyong Int J Gen Med Original Research BACKGROUND: Combined small cell lung cancer (c-SCLC) distinguishes itself from small cell lung cancer (SCLC) due to its inclusion of both SCLC and non-small cell lung cancer (NSCLC) components. Few studies have compared clinicopathological characteristics, prognosis and factors affecting survival. We therefore addressed the issues in this study. PATIENTS AND METHODS: A total of 400 c-SCLC and 20,841 SCLC patients were enrolled using SEER database. Difference in clinicopathological characteristics of SCLC and c-SCLC patients was analyzed using chi-square. Kaplan–Meier was applied to compare their survival before and after propensity score matching (PSM). Cox regression model was adopted to assess the impact of different clinical variables on survival. Logistic regression was applied to identify risk factors for c-SCLC and SCLC patients. RESULTS: Differences in race, sex, T stage, N stage, surgery, bone, brain and liver metastasis were detected between c-SCLC and SCLC patients. c-SCLC patients had better overall survival (OS) than SCLC patients before PSM. Age, race, sex, T stage, N stage, surgery, bone, brain, liver and lung metastasis were prognostic factors affecting OS for c-SCLC and SCLC (P < 0.05). However, a significant OS benefit was not observed in c-SCLC after adjusting for clinicopathological variables (HR, 0.950; 95% CI, 0.842–1.073; P=0.411). No significant OS difference was found between c-SCLC and SCLC patients after PSM (P = 0.789). c-SCLC patients had lower risk of lymph node (OR: 0.555; 95% CI: 0.439–0.703; P < 0.001) and liver metastasis (OR: 0.591; 95% CI: 0.448–0.779; P < 0.001), whereas had no significant differences in bone and brain metastasis risks (P > 0.05) compared with SCLC patients. CONCLUSION: The prognosis of c-SCLC did not significantly differ from that of SCLC if clinicopathological characteristics are controlled. Better prognosis for c-SCLC patients over SCLC patients may be ascribed to fewer liver and lymph node metastases upon diagnosis. Dove 2021-10-18 /pmc/articles/PMC8536838/ /pubmed/34703294 http://dx.doi.org/10.2147/IJGM.S332725 Text en © 2021 Zhang et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Zhang, Chenyue Shang, Xiaoling Sun, Jian Li, Zhenxiang Lin, Jiamao Zhao, Chenglong Wang, Haiyong Clinicopathological Difference and Survival Impact of Patients with c-SCLC and SCLC |
title | Clinicopathological Difference and Survival Impact of Patients with c-SCLC and SCLC |
title_full | Clinicopathological Difference and Survival Impact of Patients with c-SCLC and SCLC |
title_fullStr | Clinicopathological Difference and Survival Impact of Patients with c-SCLC and SCLC |
title_full_unstemmed | Clinicopathological Difference and Survival Impact of Patients with c-SCLC and SCLC |
title_short | Clinicopathological Difference and Survival Impact of Patients with c-SCLC and SCLC |
title_sort | clinicopathological difference and survival impact of patients with c-sclc and sclc |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8536838/ https://www.ncbi.nlm.nih.gov/pubmed/34703294 http://dx.doi.org/10.2147/IJGM.S332725 |
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