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New dilemmas in small-cell lung cancer TNM clinical staging

Authors Zarogoulidis K, Latsios D, Porpodis K, Zarogoulidis P, Darwiche K, Antoniou N, Hohenforst-Schmidt W, Eleftheriadou E, Boutsikou E, Kontakiotis T

Received 19 February 2013

Accepted for publication 7 April 2013

Published 16 May 2013 Volume 2013:6 Pages 539—547


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Konstantinos Zarogoulidis,1 Dimitrios Latsios,1 Konstantinos Porpodis,1 Paul Zarogoulidis,1,2 Kaid Darwiche,2 Nick Antoniou,1 Wolfgang Hohenforst-Schmidt,3 Ellada Eleftheriadou,1 Efimia Boutsikou,1 Theodoros Kontakiotis1

1Pulmonary Department-Oncology Unit, “G Papanikolaou” General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; 2University Pulmonary Department- Interventional Unit, Ruhrlandklinik, University, University of Duisburg-Essen, Essen, Germany; 3II Medical Clinic, Hospital of Coburg, University of Wuerzburg, Coburg, Germany

Background: Many patients with limited disease (LD) behave similarly to those with extensive disease (ED) from a prognostic point of view. On the other hand, a proportion of patients with ED small-cell lung cancer (SCLC) 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%) had LD, while 486 (63.6%) had ED.
Results: No statistically significant difference was observed for survival for IA and IB disease stages (P = 0.254) and between IIA and IIB stages (P = 0.256) according to the new tumor, node, metastasis (TNM) staging classification classification. In addition, no statistical significant difference was observed for survival between patients with (IIA + IIB) and IIIA (P = 0.951), (IIA + IIIA, P = 0.658), and (IIB + IIIA, P = 0.573) stages. Statistical significant difference was observed for survival among the LD SCLC patients with (IA + IB), (IIA + IIB + IIIA), and IIIB stages (P < 0.001). Similarly, statistical significance was observed for ED SCLC patients with (IIA + IIB + IIIA), IIIB, and IV stages (P < 0.001).
Conclusions: Although stratification of SCLC patients in LD and ED is generally satisfactory, the TNM staging system is recommended for more detailed prognostic information and treatment evaluation in these patients.

Keywords: small-cell lung cancer, staging, lung cancer

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