Abstract
Surgery for non-small cell lung cancer has been widely accepted for years. However, the role of surgery for small cell lung cancer (SCLC) remains controversial. We therefore performed this period propensity score matching analysis using the SEER database the Surveillance, Epidemiology, and End Results (SEER) Registry database to explore the role of surgery on survival in patients with SCLC. Patients with SCLC from 2010 to 2015 were identified from the SEER. Individual data for each case were retrieved regarding general clinical characteristics, surgery of primary site, cause-specific death classification and survival time. Differences of cause-specific survival (CSS) between subgroups were estimated by log-rank test. Cox regression analysis was used to evaluate the effects of multiple variables on CSS. Difference of cause-specific death incidence was examined using chi-square (Chi2) test. 1707 records met the criteria and were retrieved for analysis. There were significant differences of CSS in Clinical pathological features of N (P=0.01), Stage (P=0.00), and Surgery (P=0.00) when compared non-surgery with surgery, and in N (P=0.000), Stage (P=0.006), Surgery (P=0.049) compared sublobectomy with lobectomy or bilobectomy (bi-/lobectomy). More patients who did not receive surgery (P=0.00) or received sublobectomy (P=0.03) were at risk of death compared with receiving surgery and bi-/lobectomy respectively (Fig 1 and 2).View Large Image Figure ViewerDownload Hi-res image Download (PPT) To conclude, surgery should be taken into account when initial treatment strategy is made in SCLC patients with clinical stage I-IIA (T1-2,N0,M0) even age older than 50 years, in spite of sex, histology and grad. It seems that some SCLC patients with stage IIB (N1) can also benefit from bi-/lobectomy, although further investigation is needed. Simultaneously, bi-/lobectomy is preferred than sublobectomy when a surgery is performed. However, the role of pneumonectomy for SCLC is unclear in this study.
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