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Clinical manifestation and survival of patients with small-cell lung cancer.

OBJECTIVE
To assess the clinical manifestation, diagnostic investigation, treatment, and survival of patients with small-cell lung cancer (SCLC).


DESIGN
Retrospective study.


MATERIAL AND METHOD
Patients with histologically and/or cytologically proven SCLC, adequate medical record for clinical history, and survival between January 1, 1999 and December 31, 2003, were reviewed. The stage of disease at presentation was based on the Veterans' Administration Lung Cancer Study Group (VALSG) staging system of limited-stage and extensive-stage disease.


RESULTS
One hundred and sixteen evaluative SCLC patients were enrolled in the present study. SCLC was common in elderly men who smoked. Major symptoms were cough 81%, weight loss 72%, and dyspnea 67%. Hoarseness and superior vena cava syndrome (SVC syndrome) were present in 18% and 17% respectively. Forty-nine patients (42%) presented with limited-stage disease and 67 (58%) with extensive-stage disease. Thirty patients (26%) received chemotherapy alone, 23 patients (20%) received radiotherapy alone, 33 patients (28%) received combined chemoradiotherapy, and 30 patients (26%) received supportive treatment. A chemotherapy regimen of cisplatin combined with etoposide was used in 61 of 63 patients (97%). The overall response to chemotherapy was complete remission in 12 cases (19%), and partial response in 20 cases (32%). The median survival of limited-stage disease was significantly better than those with extensive-stage disease (44 weeks vs. 22 weeks). Patients with chemotherapy treatment had significantly improved median survival in both limited-stage and extensive-stage disease.


CONCLUSION
More than half of the SCLC patients presented in extensive-stage disease. The majority of the patients were treated with systemic chemotherapy. Patients with limited-stage disease had better response to chemotherapy and better survival than those with extensive-stage disease.