title: Prognostic impact of clinical variables on surgically resected small-cell lung cancer: Results of a retrospective multicenter analysis (FIGHT002A and HOT1301A).
abstract: OBJECTIVE
  Several American and Japanese guidelines recommend surgery for patients with c-stage I small-cell lung cancer (SCLC), whereas the European Society of Medical Oncology (ESMO) guidelines recommend surgery for patients with not only c-stage I but also c-stage II (T2N1) SCLC. In addition, previous studies identified various factors other than clinical stage that are related to survival in these patients. Thus, further validation and examination of the association of clinical stage and other clinical variables with survival are required for establishing practical management of early-stage SCLC.
  
  
  METHODS
  We reviewed the clinical courses of 156 SCLC patients who had undergone surgery at 17 institutions between January 2003 and January 2013.
  
  
  RESULTS
  Clinical stages (tumor-node-metastasis [TNM] version 7) of the 156 patients were 98 cases in IA, 14 in IB, 16 in IIA, 7 in IIB, 18 in IIIA, and 3 in IIIB. Median overall survival (OS) was 33.3 months (95% confidence interval: 20.9-45.8). Multivariate analysis revealed that OS was longer in patients either at c-stage II and under, with a maximum tumor diameter of <20mm, with preoperative diagnosis, without a history or presence of other types of cancer, or who underwent prophylactic cranial irradiation (PCI).
  
  
  CONCLUSIONS
  These results indicate that a history or presence of other types of cancer might be a major decisive factor for surgery. Patients with c-stages I and II (c-T2N1) can be considered for surgery, and PCI may be useful in patients undergoing surgery in a practical setting, partly supporting the ESMO guidelines.(1).
authors.affiliation: Department of Pulmonary Medicine, Fukushima Medical University, Fukushima 960-1295, Japan. Electronic address: hyokouch@gmail.com.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yokouchi
authors.affiliation: Department of Pulmonary Medicine, Fukushima Medical University, Fukushima 960-1295, Japan; Clinical Oncology Center, Fukushima Medical University Hospital, Fukushima 960-1295, Japan. Electronic address: taku.ishida@nifty.ne.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ishida
authors.affiliation: Department of Thoracic Surgery, Sapporo Keiyukai Hospital, Sapporo 003-0027, Japan. Electronic address: shigeoy@coral.ocn.ne.jp.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Yamazaki
authors.affiliation: First Department of Medicine, Hokkaido University School of Medicine, 060-8638 Sapporo, Japan. Electronic address: hajime1first@yahoo.co.jp.
authors.forename: Hajime
authors.initials: H
authors.lastname: Kikuchi
authors.affiliation: First Department of Medicine, Hokkaido University School of Medicine, 060-8638 Sapporo, Japan. Electronic address: soizumi@med.hokudai.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Oizumi
authors.affiliation: Second Department of Surgery, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan; Division of Thoracic Surgery, Saitama Cancer Center, Ina 362-0806, Japan. Electronic address: hidetaka@cancer-c.pref.saitama.jp.
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Uramoto
authors.affiliation: Second Department of Surgery, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan. Electronic address: ftanaka@med.uoeh-u.ac.jp.
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Tanaka
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Hokkaido Cancer Center, Sapporo 003-0804, Japan. Electronic address: mharada@sap-cc.go.jp.
authors.forename: Masao
authors.initials: M
authors.lastname: Harada
authors.affiliation: Department of Respiratory Disease, Sapporo City General Hospital, Sapporo 060-8604, Japan. Electronic address: kenji.akie@doc.city.sapporo.jp.
authors.forename: Kenji
authors.initials: K
authors.lastname: Akie
authors.affiliation: Department of Respiratory Medicine, Teine Keijinkai Hospital, Sapporo 006-8555, Japan. Electronic address: fsugaya@r5.dion.ne.jp.
authors.forename: Fumiko
authors.initials: F
authors.lastname: Sugaya
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Asahikawa Medical Center, Asahikawa 070-8644, Japan. Electronic address: yuka-1@hosp.go.jp.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Fujita
authors.affiliation: Department of Respiratory Medicine, Miyagi Cancer Center, Natori 981-1293, Japan. Electronic address: fukuhara-tatsuro@miyagi-pho.jp.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Fukuhara
authors.affiliation: First Department of Medicine, Obihiro Kosei Hospital, Obihiro 080-0016, Japan. Electronic address: keitak@hokkaido.med.or.jp.
authors.forename: Kei
authors.initials: K
authors.lastname: Takamura
authors.affiliation: Department of Medical Oncology, KKR Sapporo Medical Center, Sapporo 062-0931, Japan. Electronic address: kotetsu@kkr-smc.com.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kojima
authors.affiliation: Center for Respiratory Diseases, JCHO Hokkaido Hospital, Sapporo 062-8618, Japan. Electronic address: harada-toshiyuki@hokkaido.jcho.go.jp4.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Harada
authors.affiliation: Department of Thoracic Surgery, Fukushima Red Cross Hospital, Fukushima 960-8530, Japan; Department of Thoracic Surgery, Fukushima Medical University, Fukushima 960-1295, Japan. Electronic address: higuchi@fmu.ac.jp.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Higuchi
authors.affiliation: Center of Respiratory Disorders, Ohta Nishinouchi Hospital, Koriyama 963-8558, Japan. Electronic address: sleepy7@ohta-hp.or.jp.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Matsuura
authors.affiliation: Department of Respiratory Medicine, Sapporo-Kosei General Hospital, Sapporo 060-0033, Japan. Electronic address: tourbillon@w7.dion.ne.jp.
authors.forename: Osamu
authors.initials: O
authors.lastname: Honjo
authors.affiliation: Respiratory Center, Asahikawa Medical University, Asahikawa 078-8510, Japan. Electronic address: yminami@asahikawa-med.ac.jp.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Minami
authors.affiliation: Department of Internal Medicine, Sunagawa City Medical Center, Sunagawa 073-0196, Japan. Electronic address: naomiwatanabe1961@gmail.com.
authors.forename: Naomi
authors.initials: N
authors.lastname: Watanabe
authors.affiliation: Department of Translational Pathology, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan. Electronic address: hnishihara@med.hokudai.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nishihara
authors.affiliation: Department of Thoracic Surgery, Fukushima Medical University, Fukushima 960-1295, Japan. Electronic address: hiro@fmu.ac.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Medical Oncology, Hokkaido University Graduate School of Medicine, 060-8638 Sapporo, Japan. Electronic address: hdakita@med.hokudai.ac.jp.
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Dosaka-Akita
authors.affiliation: Department of Medical Oncology, KKR Sapporo Medical Center, Sapporo 062-0931, Japan. Electronic address: h-isobe@kkr-smc.com.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Isobe
authors.affiliation: First Department of Medicine, Hokkaido University School of Medicine, 060-8638 Sapporo, Japan. Electronic address: ma-nishi@med.hokudai.ac.jp.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nishimura
authors.affiliation: Department of Pulmonary Medicine, Fukushima Medical University, Fukushima 960-1295, Japan. Electronic address: munakata@fmu.ac.jp.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Munakata
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers
keywords: Preoperative diagnosis; Prophylactic cranial irradiation; Small-cell lung cancer; Surgery; c-Stage II