Prognostic factor analysis of patients with small cell lung cancer: Real-world data from 988 patients

Small cell lung cancer (SCLC) is characterized by aggressive spread and poor prognosis, but has limited treatment options. Results of prognostic factors from randomized trials on treatment arrangement are conflicting and large-scale real-world analysis is lacking.

Patients diagnosed SCLC between 2008 and 2018 in Peking University Cancer Hospital were included in this study. Kaplan-Meier methods were adopted, and univariate analysis and multivariate Cox regression models were constructed to analyze prognostic factors.

Among 1045 patients who presented to our center, 988 eligible patients were identified. Median overall survival (OS) was 16.0 months for the whole group, 24.0 months and 11.0 months for limited stage small cell lung cancer (LS-SCLC) and extensive stage small cell lung cancer (ES-SCLC), separately. Limited-stage, good performance status (PS) (ECOG 0-1), response to primary systemic treatment, and patients who received initiative irradiation and three or more lines of chemotherapy were predicted to have better OS in the whole group. Only response to first-line systemic therapy and prophylactic cranial irradiation (PCI) were independent prognostic factors of survival in LS-SCLC; while good PS (ECOG 0-1), without liver, bone, or subcutaneous metastases, response to first-line therapy, initial local irradiation, and three or more lines of systemic therapy predicted a favorable prognosis in ES-SCLC.

The present study retrieved from large real-world data suggested that response to primary systemic therapy and aggressive radiotherapy are independent prognostic factors for SCLC. PCI and initiative irradiation for original or metastatic sites improved the OS in LS-SCLC and ES-SCLC, respectively.