Neoadjuvant chemotherapy's value and significance in combining with surgical treatment for limited small cell lung cancer (LD-SCLC) / 中华胸心血管外科杂志

ABSTRACT

Objective To analyze and evaluate neoadjuvant chemotherapy's value and significance in combining with surgical treatment for limited small cell lung cancer(LD-SCLC).Methods A total of 94 LD-SCLC patients underwent complete resections combined with chemotherapy between January 2000 and January 2011 in Shanghai Pulmonary Hospital.Among these cases,initial two cycles of neoadjuvant chemotherapies were performed for all pathologically confirmed patients (Group A),and initial operations followed by adjuvant chemotherapy were administered to patients without pathology (Group B).The survival rate was analyzed by log-rank test and Kaplan-Meier method.Multivariate analysis of the prognostic factors was performed using Cox's regression model.Results Group A included 43 cases and Group B included 51 cases.The mean age was (56.37 ± 10.18) years.According to the 6th edition of Tumor,Node,Metastasis(TNM) classification of lung cancer,54 cases were at stage Ⅰ or Ⅱ,40 cases were at stage Ⅲ.Overall 5-year survival(5-YS) was 27％.The 5-YS for patients with stage Ⅰ-Ⅱ was notably better than that of stage Ⅲ (34％ vs 20％,P =0.033).For patients with stage Ⅲ,the 5-YS of Group A was significantly better than that of Group B(34％ vs 12％,P =0.020),besides median overall survival for Group A and Group B were 46 and 15 months(P =0.009).Furthermore,the results of multivariate analysis showed that neoadjuvant chemotherapy,surgery and histopathology of SCLC were independent factors that strongly affected survival and prognosis.Conclusion In combined surgical treatment for LD-SCLC,neoadjuvant chemotherapy obviously improved the prognosis of patients with stage Ⅲ.Therefore,it was very important and necessary that pre-surgical neoadjuvant chemotherapy was administered to resectable stage Ⅲ LD-SCLC patients.