Survival Trends for Patients with Small Cell Lung Cancer (SCLC) in the United States: Analysis of the SEER Database - Abstract
Background: Small cell lung cancer (SCLC) generally has poor outcomes. The last thirty years have seen some improvement in management options for these patients, but their impact on the general population is unclear. Objective: The present study analyzed trends in the diagnosis and survival of SCLC patients between 1988 and 2015. Method: The Surveillance, Epidemiology, and End Result (SEER) registry was used to identify SCLC cases from 1988 to 2015. Patients were classified as having either limited stage (LS) or extensive stage (ES) disease. Cox regressions were used to compare overall survival (OS). Results: We analyzed 98,281 SCLC patients. More males were diagnosed with ES-SCLC and had worse OS compared to females (HR: 1.14 [CI 1.11-1.16]). Although younger patients had higher proportion of ES-SCLC diagnosis, the older patients had worse OS for both stages (LS-SCLC: HR 1.36 [CI 1.32-1.40]; ES-SCLC: HR: 1.34 [CI 1.31-1.36]). Among LS-SCLC, Blacks had worse OS compared to Whites (LS-SCLC: HR 1.06 [CI 1.02-1.10]) and no differences in OS in ES-SCLC among races. Compared to the reference period 1988-1992, patients diagnosed with ES-SCLC during the later periods had improved OS: 1998-2002 (HR: 0.97 [CI, 0.94-1.00]), 2003- 2007 (HR: 0.92 [CI 0.90-0.95]), 2008-2012 (HR: 0.91 [CI 0.88- 0.94]), and 2013-2015 (HR: 0.91 [CI 0.88- 0.94]). Conclusion: Females, Whites, and younger patients with SCLC had better OS compared to males, Blacks, and older patients. The results show increase in OS of SCLC patients over time, particularly for those with LS-SCLC.