Ten years of disease-free survival between two diagnoses of small-cell lung cancer: a case report and a literature review.
Small-cell lung carcinoma (SCLC) represents one-fifth of all cases of bronchopulmonary cancer and has a 5-yr survival of 2-4%. Long-term survivors of SCLC are at risk for developing second primary aerodigestive tumors. We report a case of a long-term survivor who had a 10-yr disease-free survival between two diagnoses of SCLC. A literature review identified four case reports and seven review series with a total of 26 cases of 5-yr disease-free survivors of SCLC who developed a second SCLC. A total of 4574 patients were reported in the review series. Five-year disease-free survival was documented in 139 of 4574 patients. Twenty-two (15.8%) of those developed a second SCLC over the next 7 yr of follow up, with an averaged annual incidence equal to fivefold that of the general population. Earlier reports of a slow radiographic doubling time for some cases of SCLC suggests that survivors of SCLC may still develop a recurrent SCLC following 12 yr of disease-free follow up. It remains difficult to ascertain whether a second SCLC is a recurrence or a second primary tumor in the absence of a preneoplastic lesion for SCLC. New genetic markers may hold the answer. They may also help screen high-risk patients including survivors of SCLC.
Al-Ajam
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Division of Pulmonary Disease and Critical Care Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY, USA. Mohammad.AlAjam@nychhc.org
Seymour
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Mooty
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Leaf
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D018288:Carcinoma, Small Cell / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology; D018572:Disease-Free Survival; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed