EP1.12-29 Retrospective Study About Small Cell Lung Cancer: Our Experience in a Spanish Hospital

Abstract

Incidence of small cell lung cancer (SCLC) has been decreased during the last decades. This neoplasm appears almost exclusively in smokers and it is characterized by aggressive biology and early development of metastases. Due to this aggressiveness, a large proportion of patients present a poor performance status at the time of diagnosis. Though the tumor is initially highly responsive to therapies, most of the patients will relapse after treatment. The prognosis is generally poor, even in limited stage disease. We conducted a descriptive and retrospective study including all patients diagnosed with SCLC tumor between January 2012 and December 2018 (both localized and metastatic forms were included). A Kaplan Meier survival analysis (log-rank analysis) was carried out to study the overall survival. diagnosed in advanced stages (60.2%), while 29.6% were locally advanced and only 8.2%, localized. In metastatic stage, the main organ affected was the liver (35.7%), followed by the bone (24.5%). Only 12% presented brain metastases at the diagnosis. The vast majority were smokers (68.4%) or ex-smokers (27.6%), with only one patient that had never smoked. The 78.4% of the patients received chemotherapy (36.7% with concomitant radiotherapy). After the initial treatment, up to 55.4% of the patients recurred, mainly involving various localizations (50%). Only 39% received a second line of chemotherapy, and 24% a third line. At the end of the study, 84.6% of the patients had died (median of 19.7 months since diagnosis). Log-rank analysis (Kaplan-Meier estimates) showed significant differences (p<0.05) between tumor stages and platinum-sensitive status. On the contrary, there wasn't significant difference related to sex, smoke status, type of recurrence or type of chemotherapy chosen in second line. SCLC is heavily related with smoke. Most of them exhibit an aggressive behavior, with an advanced stage at diagnosis (in our study, up to 60.2%, and 29.6% locally advanced). Thought usually presents high chemosensitivity, most of the patients recur. At this point, the prognosis is poor, with a low benefit with the treatment, in our series regardless of the drug. Unlike the previous series, we haven't seen a worse outcome related to sex or smoke status. More studies will be needed to be able to clarify the prognostic impact of factors such as the smoke status, sex, type of relapse or second line treatment.