AB 18. New dilemmas in small cell lung cancer tnm clinical staging small cell lung cancer independent evaluation
Background: Many patients with Limited Disease (LD) behave
similarly to those with Extensive Disease (ED) from the prognostic
point of view. On the other hand, a proportion of patients with EDSCLC
behave similarly to those with LD.
Patients and methods: In this retrospective study analysis 764
patients with proven SCLC were included and managed with the same
therapeutic protocols. Of these patients, 278 (36.4%) has LD, while 486
(63.6%) had ED.
Results: No statistically significant difference was observed for survival
for IA and IB disease stage (P=0.254) and between IIA and IIB stage
(P=0.256) according to the new TNM classification. In addition, no
statistical significant difference was observed for survival between stage
(IIA+IIB) and IIIA stage (P=0.951), (IIA+IIIA P=0.658) and (IIB+IIIA
P=0.573). Statistical significant difference was observed for survival
among the LD SCLC patients with (IA+IB), (IIA+IIB+IIA) and IIB
stage (P<0.001). Similarly, statistical significance was observed for ED
SCLC patients with (IIA+IIB+IIIA), IIIB and IV stage (P<0.001).
Conclusions: Stratification of SCLC patients in LD and ED, although
generally satisfactory, has specific limitations, and therefore a new four
stage classification for SCLC should be established.