Small-Cell Lung Cancer in a Cancer Center in Colombia

Author(s): Carlos Carvajal, Diego-Felipe Ballén, Natallie Jurado, Rafael Beltrán, Martha-Liliana Alarcón, Camilo Vallejo-Yepes, Marcela Nuñez, Rafael Parra, Ricardo Brugés-Maya

Objective: This study aimed to describe the principal clinical features, survival outcomes, and prognostic factors of patients with small cell lung cancer (SCLC) treated at the Instituto Nacional de Cancerologia (INC) between 2013 and 2018.

Methods: A retrospective analytical study was conducted.

Results: 35 patients with SCLC were included, with a median age of 61 years (IQR=54-71), 24 of which were men (68.6%); 23 patients (65.7%) were admitted with an ECOG score ≤2, and 5 (14.3%) had no smoking history. 26 patients (74.3%) had extended, and 9 (25.7%) had limited disease. Three patients (8.6%) underwent surgical management. Three patients with limited disease received definitive chemotherapy and radiotherapy. 23 (65.7%) patients received best supportive care and 6 (17.1%) patients with extended disease received palliative chemotherapy. The median survival of the entire cohort was 4.5 months (95% CI, 2.56- 8.28). Overall survival (OS) at 1 and 3 years was 26.5% and 5.9%, respectively. The Kaplan-Meier curves showed that patients with an ECOG >2 (p<0.0014), smoking history (p=0.0026), and extended disease (p=0.0035) had a worse OS. The median survival of patients who received chemotherapy, palliative chemotherapy, and best supportive care was 29.0, 11.9, and 2.6 months, respectively. Multivariate analysis showed that the only independent variable for worse OS was ECOG >2 (HR: 2.59, 95% CI, 1.09-6.12, p=0.031).

Conclusions: SCLC has the worst prognosis among all types of lung cancer worldwide. In Colombia, the findings are no different, and additionally, survival was clearly affected in patients with ECOG>2, smoking history, and extended disease.

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