Clinical characteristics, response to treatment and survival in relation to the age, in small cells lung cancer (SCLC) patients

Background: Lung cancer is the most important cause of death from cancer. SCLC represents 20% of cases; the majority has metastatic disease, reason why survival expectancy is limited. Several clinical and biochemical factors have been analyzed as prognostic factors, age at diagnosis could influence the prognosis. Objectives: To determine overall survival, response to chemotherapy and clinical characteristics in SCLC patients younger and older than 60 years of age. Patients and methods: 39 patients with confirmed diagnosis of SCLC, both genders, were treated between January 1993 and December 2007. Two groups were designed: 1) < 60 years, 2) > 60 years. Age, oncologic family history, comorbility, smoking, symptoms, clinical stage, hemoglobin, platelets, lactic dehydrogenase, albumin serum level, synaptophisine, chromogranine A, neuronal-specific enolase, response to chemotherapy, time to progression (TTP) and overall survival were analyzed on all patients and each group. Results: From 222 cases with lung cancer, 39 were SCLC (17.5%); median age 64 years, range 45-88; 18 cases (46.1%) in group 1 and 21 (53.8%) > 60 years old (p = 0.000). We did not observe differences among gender, family history, other comorbilities, smoking, ECOG, symptoms, and clinical stage nor metastatic sites (p > 0.05). On 17 evaluable cases with stage IIIB and IV, treated with cisplatin and etoposide, we detected 2 RC (11.8%), 8 RP (47%), stable disease 2 (11.8%), progression 5 (29.4%), ORR (58.8%); median duration response 2 months (1-36), TTP 4.7 months, (0.7-36). No differences in therapeutic response or overall survival were observed in relation to age at the diagnosis (p > 0.05). ECOG, gender, age > 70 years old, and brain metastasis do not correlate with overall survival (p > 0.05). The patients with stage IIIB and IV had median overall survival 10 months while it was 11 months in stage I-IIIA, p = 0.047. Conclusions: In this study, age at the diagnosis is not a prognostic factor for survival or response to chemotherapy in SCLC. Advanced clinical stages (IIIB and IV) are the most important prognostic factor.