The prognostic factors in the elderly patients with small cell lung cancer: a retrospective analysis from a single cancer institute

Objectives: We conducted a retrospective study to evaluate the prognostic factors of elderly patients with small cell lung cancer (SCLC). Patients and methods: The records of elderly patients (>= 65 years) with histologically-proven SCLC were reviewed. The patients' information including demographic, clinical and laboratory parameters, staging status on the Veterans Administration Lung Study Group staging system, and treatment modalities were registered. Univariate and multivariate survival analysis was performed by the Kaplan-Meier method and Cox proportional hazards model, respectively. Results: Between January 2004 and December 2012, 247 elderly patients with SCLC were analyzed, 129 patients initially presented with limited stage (LS) and 118 with extensive disease (ES). The median age of the patients was 70.7 years (range, 65-83 years). The median follow-up period for all patients was 22.0 months (range, 1.0-84.0 months) and 39.9 months for the surviving patients (range, 4.7-84.0 months). The median survival time (MST) was 17.3 months, and the 2-year and 3-year OS rates were 36.3% and 22.7%, respectively. The MST, 2-year and 3-year OS rates were 22 months, 45.0% and 30.5% in patients with limited stage, versus 13.4 months, 26.5% and 13.7% in patients having extensive diseases, respectively. Multivariate analysis revealed that disease extent (HR = 3.034; P < 0.001) and the number of chemotherapy cycles (HR = 0.486; P = 0.003) were independent prognostic factors for the OS. Additionally, a normal serum NSE level (HR = 0.447, P = 0.017) at the time of diagnosis was independent positive prognostic factors for patients with LS-SCLC, but not for ES-SCLC. Conclusion: Disease extent and the number of chemotherapy cycles were independent prognostic factors of elderly patients with SCLC. The fit cohort might benefit from positive treatment.