The role of surgery in older patients with T1-2N0M0 small cell lung cancer: A propensity score matching analysis

BACKGROUND: Surgical resection could improve the survival of patients with early-stage small cell lung cancer (SCLC). However, there is a lack of dedicated studies concentrating on surgical treatment in older patients with T1-2N0M0 SCLC. Thus, we performed this population-based study to investigate...

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Autores principales: Ning, Jing, Ge, Tao, Zhu, Shuncang, Han, Yingli, Ruan, Suhong, Ma, Yuchen, Liu, Rentao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9565197/
https://www.ncbi.nlm.nih.gov/pubmed/36249007
http://dx.doi.org/10.3389/fonc.2022.958187
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author Ning, Jing
Ge, Tao
Zhu, Shuncang
Han, Yingli
Ruan, Suhong
Ma, Yuchen
Liu, Rentao
author_facet Ning, Jing
Ge, Tao
Zhu, Shuncang
Han, Yingli
Ruan, Suhong
Ma, Yuchen
Liu, Rentao
author_sort Ning, Jing
collection PubMed
description BACKGROUND: Surgical resection could improve the survival of patients with early-stage small cell lung cancer (SCLC). However, there is a lack of dedicated studies concentrating on surgical treatment in older patients with T1-2N0M0 SCLC. Thus, we performed this population-based study to investigate whether older patients with T1-2N0M0 SCLC could benefit from surgery. METHODS: We collected the data of patients with SCLC between 2000 and 2015 from the Surveillance, Epidemiology, and End Results Program database. Older patients (≥ 65 years) with T1-2N0M0 SCLC were included, and we converted the staging information into those of the eighth edition. The propensity score matching (PSM) was used to balance the distribution of clinical characteristics between surgery and no-surgery groups. RESULTS: Before PSM, the distribution proportions of clinical characteristics in 1,229 patients were unbalanced. The Kaplan–Meier curves of overall survival (OS) and cancer-specific survival (CSS) showed that the patients in the surgery group were better than those in the non-surgery group (all P < 0.001). After 1:2 PSM, the distribution proportions of clinical characteristics in 683 patients were balanced (all P > 0.05). The OS and CSS of patients in the surgery group were still better than that of patients in the no-surgery group (all P < 0.001), and subgroup analysis showed that the surgery was a protective factor for OS and CSS in all clinical characteristics subgroups (almost P < 0.001). The multivariate Cox analysis further confirmed this result (OS: HR, 0.33; 95% CI, 0.27–0.39; P < 0.001; CSS: HR, 0.29; 95% CI, 0.23–0.36; P < 0.001). The result of subgroup analysis based on age, T stage, and adjuvant therapy showed that surgery was related to better OS and CSS compared with non-surgery group (almost P < 0.001) and that lobectomy exhibited the longer survival than sublobectomy. Age, sex, and race were the independent prognostic factors for OS in patients undergoing surgery, whereas only the factor of age affects the CSS in patients with surgery. CONCLUSIONS: Older patients with T1-2N0M0 SCLC can benefit significantly from surgical treatment, and lobectomy provides better prognosis than sublobectomy.
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spelling pubmed-95651972022-10-15 The role of surgery in older patients with T1-2N0M0 small cell lung cancer: A propensity score matching analysis Ning, Jing Ge, Tao Zhu, Shuncang Han, Yingli Ruan, Suhong Ma, Yuchen Liu, Rentao Front Oncol Oncology BACKGROUND: Surgical resection could improve the survival of patients with early-stage small cell lung cancer (SCLC). However, there is a lack of dedicated studies concentrating on surgical treatment in older patients with T1-2N0M0 SCLC. Thus, we performed this population-based study to investigate whether older patients with T1-2N0M0 SCLC could benefit from surgery. METHODS: We collected the data of patients with SCLC between 2000 and 2015 from the Surveillance, Epidemiology, and End Results Program database. Older patients (≥ 65 years) with T1-2N0M0 SCLC were included, and we converted the staging information into those of the eighth edition. The propensity score matching (PSM) was used to balance the distribution of clinical characteristics between surgery and no-surgery groups. RESULTS: Before PSM, the distribution proportions of clinical characteristics in 1,229 patients were unbalanced. The Kaplan–Meier curves of overall survival (OS) and cancer-specific survival (CSS) showed that the patients in the surgery group were better than those in the non-surgery group (all P < 0.001). After 1:2 PSM, the distribution proportions of clinical characteristics in 683 patients were balanced (all P > 0.05). The OS and CSS of patients in the surgery group were still better than that of patients in the no-surgery group (all P < 0.001), and subgroup analysis showed that the surgery was a protective factor for OS and CSS in all clinical characteristics subgroups (almost P < 0.001). The multivariate Cox analysis further confirmed this result (OS: HR, 0.33; 95% CI, 0.27–0.39; P < 0.001; CSS: HR, 0.29; 95% CI, 0.23–0.36; P < 0.001). The result of subgroup analysis based on age, T stage, and adjuvant therapy showed that surgery was related to better OS and CSS compared with non-surgery group (almost P < 0.001) and that lobectomy exhibited the longer survival than sublobectomy. Age, sex, and race were the independent prognostic factors for OS in patients undergoing surgery, whereas only the factor of age affects the CSS in patients with surgery. CONCLUSIONS: Older patients with T1-2N0M0 SCLC can benefit significantly from surgical treatment, and lobectomy provides better prognosis than sublobectomy. Frontiers Media S.A. 2022-09-30 /pmc/articles/PMC9565197/ /pubmed/36249007 http://dx.doi.org/10.3389/fonc.2022.958187 Text en Copyright © 2022 Ning, Ge, Zhu, Han, Ruan, Ma and Liu https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Ning, Jing
Ge, Tao
Zhu, Shuncang
Han, Yingli
Ruan, Suhong
Ma, Yuchen
Liu, Rentao
The role of surgery in older patients with T1-2N0M0 small cell lung cancer: A propensity score matching analysis
title The role of surgery in older patients with T1-2N0M0 small cell lung cancer: A propensity score matching analysis
title_full The role of surgery in older patients with T1-2N0M0 small cell lung cancer: A propensity score matching analysis
title_fullStr The role of surgery in older patients with T1-2N0M0 small cell lung cancer: A propensity score matching analysis
title_full_unstemmed The role of surgery in older patients with T1-2N0M0 small cell lung cancer: A propensity score matching analysis
title_short The role of surgery in older patients with T1-2N0M0 small cell lung cancer: A propensity score matching analysis
title_sort role of surgery in older patients with t1-2n0m0 small cell lung cancer: a propensity score matching analysis
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9565197/
https://www.ncbi.nlm.nih.gov/pubmed/36249007
http://dx.doi.org/10.3389/fonc.2022.958187
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