Prognostic significance of the 8th edition of the TNM classification for patients with extensive disease small cell lung cancer

• Published in: Cancer management and research Vol. 10; pp. 6039 - 6047
• Main Authors: Shirasawa, Masayuki, Fukui, Tomoya, Kusuhara, Seiichiro, Hiyoshi, Yasuhiro, Ishihara, Mikiko, Kasajima, Masashi, Nakahara, Yoshiro, Otani, Sakiko, Igawa, Satoshi, Yokoba, Masanori, Mitsufuji, Hisashi, Kubota, Masaru, Katagiri, Masato, Sasaki, Jiichiro, Naoki, Katsuhiko
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2018; Taylor & Francis Ltd; Dove Medical Press
• Subjects: Albumin; Cancer patients; Cancer research; Cancer staging; Cancer therapies; Carboplatin; Care and treatment; Classification; Committees; extensive disease; Family medical history; Health aspects; Laboratories; Lung cancer; Lymphatic system; Medical prognosis; Medical research; Metastasis; NMR; Non-small cell lung cancer; Nuclear magnetic resonance; Oncology; Original Research; Patients; Prognosis; Radiation therapy; Risk factors; Small cell lung cancer; TNM stage; Tomography; Tumors; Japan; extensive disease; small cell lung cancer; TNM stage; prognosis
• ISSN: 1179-1322; 1179-1322
• DOI: 10.2147/CMAR.S181789

Small cell lung cancer (SCLC) is typically categorized according to disease extent as limited or extensive, and utility of the 8th TNM classification, recommended for lung cancer staging, which demonstrates a strong association with non-small-cell lung cancer (NSCLC) management, remains unclear. This retrospective study included 277 consecutive SCLC patients treated at a single institution between 2008 and 2016. According to the currently used two-stage system, 186 (65.7%) of the patients were classified as having extensive disease (ED)-SCLC. Among the ED-SCLC patients, ten (5.3%), 38 (20.4%), 32 (17.2%), and 106 (57.0%) were categorized into stages M0, M1a, M1b, and M1c, respectively, according to the 8th TNM classification. There was a significant difference in overall survival based on the M descriptors: 15.8 (95% CI 9.4-22.2) months in the M1b group vs 7.3 (95% CI 5.7-8.9) months in the M1c group ( <0.001). Multivariate analysis showed that in addition to the known prognostic factors such as performance status, serum albumin, and lactate dehydrogenase, M descriptor was a prognostic factor (HR 1.95, 95% CI 1.38-2.77; <0.001). The 8th TNM classification has a prognostic value in SCLC. Similarly to NSCLC, treatment approaches should be considered on the basis of the 8th TNM classification, especially stage IVA separate from stage IVB in ED-SCLC patients.