New insights into stage and prognosis in small cell lung cancer: an analysis of 968 cases

Background: The French College of General Hospital Respiratory Physicians conducted two studies that consecutively included all patients followed in participating general hospitals for primary small cell (SCLC) or non-small cell (NSCLC) lung cancer diagnosed in 2000 and 2010. These studies allow descriptive statistics and outcome assessment for SCLC and NSCLC separately and comparison over a 10-year period. Methods: A standardised form was completed for each patient at inclusion. Then, vital status was collected. Results: In 2000 and 2010, 948 (15.5% female) and 968 (23.3%) SCLC patients, mainly heavy active-or former-smoker seniors, participated in these studies. One-year survival rate was 35.8% for SCLC vs. 44.8% for NSCLC in 2010 and 33.1% for SCLC in 2000. In 2010, in reference to stage 0-IIB (4.1% of SCLCs), the hazard ratio was 0.92 [95% confidence interval (CI): 0.6-1.5; P=0.76], 1.8 (95% CI: 1.1-2.8; P=0.019), and 3.4 (95% CI: 2.2-5.3; P<0.001) for stage IIIA (10.2%), IIIB (14.5%), and IV (71.2%). Positron emission tomography (PET)-scan use, which has increased in 10 years, was frequent in patients with limited disease. Conclusions: One-year survival in SCLC patients was poor in 2010 and dependent of SCLC stage. TNM classification reintroduction and new diagnostic techniques (e.g., PET-scan) should allow lung oncologists to tailor treatment based on disease stage at diagnosis.