To evaluate the impact of surgery-based treatment for limited-stage small cell lung cancer (LS-SCLC) and identify specific prognostic factors such as pTNM stage and treatment modalities.
Key Findings:
Median overall survival (OS) was 81 months with a 5-year OS rate of 58.3%.
Median disease-free survival (DFS) was 50 months with a 5-year DFS rate of 50.5%.
Stage I-IIA patients had significantly better survival compared to stage IIB-IIIB (5-year OS: 69.2% vs. 47.1%).
Advanced pathological Tumor-Node-Metastasis (pTNM) stage was identified as an independent adverse prognostic factor.
Adjuvant chemotherapy plus thoracic radiotherapy improved survival outcomes.
Postoperative brain metastasis was associated with markedly poor outcomes (5-year OS: 21.9% vs. 74.6%).
Interpretation:
Radical surgery followed by adjuvant therapy is associated with improved survival in LS-SCLC, particularly in earlier stages. However, findings need prospective validation due to the absence of a non-surgical control group.
Limitations:
Retrospective design limits causal inferences.
Absence of a non-surgical control group.
Selection bias due to a highly selected patient cohort, which may not represent the general LS-SCLC population.
Conclusion:
Surgical intervention combined with adjuvant therapy may enhance survival in LS-SCLC, particularly for stage IIB or higher, warranting further investigation.
