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Updated: Feb 15, 2026

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Survival in Limited Disease Small Cell Lung Cancer According to N3 Lymph Node Involvement
Christine D Valan1,2, Jens E Slagsvold2, Tarje Onsøien Halvorsen3,2
1Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway christine.valan@icloud.com.
Background/Aim:
There are several definitions of limited disease (LD) in small cell lung cancer (SCLC), differing with respect to N3 disease accepted. We analyzed patients from a randomized trial comparing two schedules of thoracic radiotherapy (TRT) in LD SCLC to investigate whether there were survival differences between N3 subcategories (n=144).
Patients And Methods:
Patients with a baseline CT scan available were analysed. Patients received four courses of cisplatin/etoposide and TRT of 45 Gy/30 fractions (twice daily) or 42 Gy/15 fractions (once daily).
Results:
Median overall survival (OS) was 23.3 months in the whole cohort. N3-patients (n=37) had shorter survival than those with N0-2 (16.7 vs. 33.0 months; p<0.001). There were no significant OS-differences between the N3 subcategories, but patients with metastases to two or more N3 regions had shorter survival than other N3 patients (13.4 vs. 19.9 months; p=0.011).
Conclusion:
There were no survival differences between the N3 subcategories, suggesting that all N3 disease should be considered as LD.
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