Small cell carcinoma of the lung natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
The natural history of untreated small cell lung cancer (SCLC) is extremely poor, with median survival of only 2 months for stage IV SCLC and less than 3 to 4 months for tumors confined to the thorax.<ref name="GreenHumphrey1969">{{cite journal|last1=Green|first1=Robert A.|last2=Humphrey|first2=Edward|last3=Close|first3=Henry|last4=Patno|first4=Mary Ellen|title=Alkylating agents in bronchogenic carcinoma|journal=The American Journal of Medicine|volume=46|issue=4|year=1969|pages=516–525|issn=00029343|doi=10.1016/0002-9343(69)90071-0}}</ref> | |||
==Natural history== | ==Natural history== |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The natural history of untreated small cell lung cancer (SCLC) is extremely poor, with median survival of only 2 months for stage IV SCLC and less than 3 to 4 months for tumors confined to the thorax.[1]
Natural history
Limited-stage disease
At the time of diagnosis, approximately 30% of patients with SCLC will have tumor confined to the hemithorax of origin, the mediastinum, or the supraclavicular lymph nodes. These patients are designated as having limited-stage disease, and most 2-year disease-free survivors come from this group. In limited-stage disease, median survival of 16 to 24 months with current forms of treatment can reasonably be expected. A small proportion of patients with limited-stage disease may benefit from surgery with or without adjuvant chemotherapy; these patients have an even better prognosis.
Extensive-stage disease
Patients with tumors that have spread beyond the supraclavicular areas are said to have extensive-stage disease and have a worse prognosis than patients with limited-stage disease. Median survival of 6 to 12 months is reported with currently available therapy, but long-term disease-free survival is rare.
Complications
Prognosis
Prognostic factors
The pretreatment prognostic factors that consistently predict for prolonged survival include good performance status, female gender, and limited-stage disease. Patients with involvement of the central nervous system or liver at the time of diagnosis have a significantly worse outcome. In general, patients who are confined to bed tolerate aggressive forms of treatment poorly, have increased morbidity, and rarely attain 2-year disease-free survival; however, patients with poor performance status can often derive significant palliative benefit and prolongation of survival from treatment.
Regardless of stage, the current prognosis for patients with SCLC is unsatisfactory even though considerable improvements in diagnosis and therapy have been made during the past 10 to 15 years.
For most patients with small cell lung cancer, current treatments do not cure the cancer. The prognosis of small cell carcinoma of the lung depend on the following:
- The stage of the cancer
- The blood level of lactate dehydrogenase (LDH)
- The patient’s gender and general health
References
- ↑ Green, Robert A.; Humphrey, Edward; Close, Henry; Patno, Mary Ellen (1969). "Alkylating agents in bronchogenic carcinoma". The American Journal of Medicine. 46 (4): 516–525. doi:10.1016/0002-9343(69)90071-0. ISSN 0002-9343.