Small cell carcinoma of the lung natural history, complications and prognosis: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
 
(47 intermediate revisions by 7 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
Please help WikiDoc by adding content here.  It's easy!  Click  [[Help:How_to_Edit_a_Page|here]]  to learn about editing.
{{Small cell carcinoma of the lung}}
{{Small cell carcinoma of the lung}}


{{CMG}}
{{CMG}}; {{AE}} {{VR}}
 
==Overview==
==Overview==
The [[Natural history of disease|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]]. With the current treatment modalities, the median survival of patients with limited stage disease ranges from 16 to 24 months while that of patients with extensive-stage disease ranges from 6 to 12 months. SCLC can be complicated by [[paraneoplastic syndrome]]s. Limited stage disease, absence of [[brain]] [[metastasis]], young age, and female sex are considered good [[prognostic]] factors.
==Natural History, Complications, and Prognosis==
=== Natutral History ===
* Approximately 30% of the [[Patient|patients]] with SCLC have limited stage disease which is characterized by a [[tumor]] confined to the hemithorax of origin, the [[mediastinum]], or the [[supraclavicular]] [[lymph nodes]].
* [[Patients]] with extensive-stage disease have [[tumors]] that have spread beyond the [[supraclavicular]] areas.<ref name="NCI">General Information About Small Cell Lung Cancer. National cancer institute. Accessed on June 17.[http://www.cancer.gov/cancertopics/pdq/treatment/small-cell-lung/healthprofessional/page1]</ref><ref name="pmid3015384">{{cite journal| author=Osterlind K, Andersen PK| title=Prognostic factors in small cell lung cancer: multivariate model based on 778 patients treated with chemotherapy with or without irradiation. | journal=Cancer Res | year= 1986 | volume= 46 | issue= 8 | pages= 4189-94 | pmid=3015384 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3015384  }} </ref><ref name="pmid17214347">{{cite journal| author=Brueckl WM, Herbst L, Lechler A, Fuchs F, Schoeberl A, Zirlik S et al.| title=Predictive and prognostic factors in small cell lung carcinoma (SCLC)--analysis from routine clinical practice. | journal=Anticancer Res | year= 2006 | volume= 26 | issue= 6C | pages= 4825-32 | pmid=17214347 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17214347  }} </ref><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>
===Complications===
=====Complications of the Disease Itself=====
*[[SIADH]]<ref name="pmid16813730">{{cite journal| author=Gandhi L, Johnson BE| title=Paraneoplastic syndromes associated with small cell lung cancer. | journal=J Natl Compr Canc Netw | year= 2006 | volume= 4 | issue= 6 | pages= 631-8 | pmid=16813730 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16813730  }} </ref>
*[[Cushing syndrome]] (due to production of [[ACTH]])<ref name="pmid16813730">{{cite journal| author=Gandhi L, Johnson BE| title=Paraneoplastic syndromes associated with small cell lung cancer. | journal=J Natl Compr Canc Netw | year= 2006 | volume= 4 | issue= 6 | pages= 631-8 | pmid=16813730 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16813730  }} </ref>
*[[Hypertension]] (due to production of [[renin]])<ref name="pmid16813730">{{cite journal| author=Gandhi L, Johnson BE| title=Paraneoplastic syndromes associated with small cell lung cancer. | journal=J Natl Compr Canc Netw | year= 2006 | volume= 4 | issue= 6 | pages= 631-8 | pmid=16813730 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16813730  }} </ref>
*[[Amenorrhea]]  (due to production of [[prolactin]] or [[growth hormone]])<ref name="pmid16813730">{{cite journal| author=Gandhi L, Johnson BE| title=Paraneoplastic syndromes associated with small cell lung cancer. | journal=J Natl Compr Canc Netw | year= 2006 | volume= 4 | issue= 6 | pages= 631-8 | pmid=16813730 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16813730  }} </ref>
*[[Galactorrhea]]  (due to production of [[prolactin]] or [[growth hormone]])<ref name="pmid16813730">{{cite journal| author=Gandhi L, Johnson BE| title=Paraneoplastic syndromes associated with small cell lung cancer. | journal=J Natl Compr Canc Netw | year= 2006 | volume= 4 | issue= 6 | pages= 631-8 | pmid=16813730 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16813730  }} </ref>
* Increased production of [[amylase]]<ref name="pmid16813730">{{cite journal| author=Gandhi L, Johnson BE| title=Paraneoplastic syndromes associated with small cell lung cancer. | journal=J Natl Compr Canc Netw | year= 2006 | volume= 4 | issue= 6 | pages= 631-8 | pmid=16813730 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16813730  }} </ref>
* Excessive [[parathormone]] ([[Parathyroid hormone|PTH]]) secretion<ref name="pmid17918299">{{cite journal| author=Radulescu D, Pripon S, Bunea D, Ciuleanu TE, Radulescu LI| title=Endocrine paraneoplastic syndromes in small cell lung carcinoma. Two case reports. | journal=J BUON | year= 2007 | volume= 12 | issue= 3 | pages= 411-4 | pmid=17918299 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17918299  }} </ref>
*[[Lambert-Eaton myasthenic syndrome]] (LEMS)<ref name="pmid1659614">{{cite journal| author=Elrington GM, Murray NM, Spiro SG, Newsom-Davis J| title=Neurological paraneoplastic syndromes in patients with small cell lung cancer. A prospective survey of 150 patients. | journal=J Neurol Neurosurg Psychiatry | year= 1991 | volume= 54 | issue= 9 | pages= 764-7 | pmid=1659614 | doi= | pmc=PMC1014512 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1659614  }} </ref>
* Subacute [[sensory neuropathy]]<ref name="pmid1659614">{{cite journal| author=Elrington GM, Murray NM, Spiro SG, Newsom-Davis J| title=Neurological paraneoplastic syndromes in patients with small cell lung cancer. A prospective survey of 150 patients. | journal=J Neurol Neurosurg Psychiatry | year= 1991 | volume= 54 | issue= 9 | pages= 764-7 | pmid=1659614 | doi= | pmc=PMC1014512 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1659614  }} </ref>
*[[Paraneoplastic syndrome|Paraneoplastic]] [[Limbic encephalitis|limbic]] [[encephalopathy]]<ref name="pmid1329233">{{cite journal| author=Amir J, Galbraith RC| title=Paraneoplastic limbic encephalopathy as a nonmetastatic complication of small cell lung cancer. | journal=South Med J | year= 1992 | volume= 85 | issue= 10 | pages= 1013-4 | pmid=1329233 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1329233  }} </ref>
*[[Encephalomyelitis]]<ref name="pmid1329233">{{cite journal| author=Amir J, Galbraith RC| title=Paraneoplastic limbic encephalopathy as a nonmetastatic complication of small cell lung cancer. | journal=South Med J | year= 1992 | volume= 85 | issue= 10 | pages= 1013-4 | pmid=1329233 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1329233  }} </ref>
*[[Paraneoplastic cerebellar degeneration]]<ref name="pmid1329233">{{cite journal| author=Amir J, Galbraith RC| title=Paraneoplastic limbic encephalopathy as a nonmetastatic complication of small cell lung cancer. | journal=South Med J | year= 1992 | volume= 85 | issue= 10 | pages= 1013-4 | pmid=1329233 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1329233  }} </ref>
*[[Retinopathy]]<ref name="pmid1329233">{{cite journal| author=Amir J, Galbraith RC| title=Paraneoplastic limbic encephalopathy as a nonmetastatic complication of small cell lung cancer. | journal=South Med J | year= 1992 | volume= 85 | issue= 10 | pages= 1013-4 | pmid=1329233 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1329233  }} </ref>
*[[Myoclonus]]<ref name="pmid1329233">{{cite journal| author=Amir J, Galbraith RC| title=Paraneoplastic limbic encephalopathy as a nonmetastatic complication of small cell lung cancer. | journal=South Med J | year= 1992 | volume= 85 | issue= 10 | pages= 1013-4 | pmid=1329233 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1329233  }} </ref>
*[[Tripe palms]]<ref name="pmid8638207">{{cite journal| author=Mullans EA, Cohen PR| title=Tripe palms: a cutaneous paraneoplastic syndrome. | journal=South Med J | year= 1996 | volume= 89 | issue= 6 | pages= 626-7 | pmid=8638207 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8638207  }} </ref>
=====Complications of the Treatment=====
Post operative complications following surgery include:<ref name="pmid11120906">{{cite journal| author=Uramoto H, Nakanishi R, Fujino Y, Imoto H, Takenoyama M, Yoshimatsu T et al.| title=Prediction of pulmonary complications after a lobectomy in patients with non-small cell lung cancer. | journal=Thorax | year= 2001 | volume= 56 | issue= 1 | pages= 59-61 | pmid=11120906 | doi= | pmc=PMC1745907 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11120906  }} </ref>
* [[Atelectasis]]
* [[Pneumonia]]
* [[Arrhythmia]]
* [[Wound]] infection
* [[Colitis]]
* [[Liver]] dysfuntion
* [[Gastric ulcer]]
===Prognosis===
====Good Prognostic Factors====


==Natural history==
*[[Small cell carcinoma of the lung staging|Limited stage disease]]<ref name="NCI">General Information About Small Cell Lung Cancer. National cancer institute. Accessed on June 17.[http://www.cancer.gov/cancertopics/pdq/treatment/small-cell-lung/healthprofessional/page1]</ref>
===Limited-stage disease===
* Absence of brain [[metastasis]]<ref name="pmid17214347">{{cite journal| author=Brueckl WM, Herbst L, Lechler A, Fuchs F, Schoeberl A, Zirlik S et al.| title=Predictive and prognostic factors in small cell lung carcinoma (SCLC)--analysis from routine clinical practice. | journal=Anticancer Res | year= 2006 | volume= 26 | issue= 6C | pages= 4825-32 | pmid=17214347 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17214347  }} </ref>
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]].
* Young age<ref name="pmid3015384">{{cite journal| author=Osterlind K, Andersen PK| title=Prognostic factors in small cell lung cancer: multivariate model based on 778 patients treated with chemotherapy with or without irradiation. | journal=Cancer Res | year= 1986 | volume= 46 | issue= 8 | pages= 4189-94 | pmid=3015384 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3015384  }} </ref>
* Female sex<ref name="pmid3015384">{{cite journal| author=Osterlind K, Andersen PK| title=Prognostic factors in small cell lung cancer: multivariate model based on 778 patients treated with chemotherapy with or without irradiation. | journal=Cancer Res | year= 1986 | volume= 46 | issue= 8 | pages= 4189-94 | pmid=3015384 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3015384  }} </ref>
* Asian ethnicity<ref name="pmid19096304">{{cite journal| author=Ou SH, Ziogas A, Zell JA| title=Prognostic factors for survival in extensive stage small cell lung cancer (ED-SCLC): the importance of smoking history, socioeconomic and marital statuses, and ethnicity. | journal=J Thorac Oncol | year= 2009 | volume= 4 | issue= 1 | pages= 37-43 | pmid=19096304 | doi=10.1097/JTO.0b013e31819140fb | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19096304  }} </ref>
* Normal [[white blood cell count]]<ref name="pmid17214347">{{cite journal| author=Brueckl WM, Herbst L, Lechler A, Fuchs F, Schoeberl A, Zirlik S et al.| title=Predictive and prognostic factors in small cell lung carcinoma (SCLC)--analysis from routine clinical practice. | journal=Anticancer Res | year= 2006 | volume= 26 | issue= 6C | pages= 4825-32 | pmid=17214347 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17214347  }} </ref>
* Surgical resection, [[radiotherapy|radiation]], and [[chemotherapy]]<ref name="pmid22000695">{{cite journal| author=Gaspar LE, McNamara EJ, Gay EG, Putnam JB, Crawford J, Herbst RS et al.| title=Small-cell lung cancer: prognostic factors and changing treatment over 15 years. | journal=Clin Lung Cancer | year= 2012 | volume= 13 | issue= 2 | pages= 115-22 | pmid=22000695 | doi=10.1016/j.cllc.2011.05.008 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22000695  }} </ref><ref name="pmid3015384">{{cite journal| author=Osterlind K, Andersen PK| title=Prognostic factors in small cell lung cancer: multivariate model based on 778 patients treated with chemotherapy with or without irradiation. | journal=Cancer Res | year= 1986 | volume= 46 | issue= 8 | pages= 4189-94 | pmid=3015384 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3015384  }} </ref>


===Extensive-stage disease===
====Bad Prognostic Factors====
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==
*[[Small cell carcinoma of the lung staging|Extensive stage disease]]<ref name="NCI">General Information About Small Cell Lung Cancer. National cancer institute. Accessed on June 17.[http://www.cancer.gov/cancertopics/pdq/treatment/small-cell-lung/healthprofessional/page1]</ref>
*[[Lung cancer staging|TNM stage III]]<ref name="pmid17214347">{{cite journal| author=Brueckl WM, Herbst L, Lechler A, Fuchs F, Schoeberl A, Zirlik S et al.| title=Predictive and prognostic factors in small cell lung carcinoma (SCLC)--analysis from routine clinical practice. | journal=Anticancer Res | year= 2006 | volume= 26 | issue= 6C | pages= 4825-32 | pmid=17214347 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17214347  }}</ref>
* Advanced age<ref name="pmid3015384">{{cite journal| author=Osterlind K, Andersen PK| title=Prognostic factors in small cell lung cancer: multivariate model based on 778 patients treated with chemotherapy with or without irradiation. | journal=Cancer Res | year= 1986 | volume= 46 | issue= 8 | pages= 4189-94 | pmid=3015384 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3015384  }}</ref>
* Male sex<ref name="pmid3015384">{{cite journal| author=Osterlind K, Andersen PK| title=Prognostic factors in small cell lung cancer: multivariate model based on 778 patients treated with chemotherapy with or without irradiation. | journal=Cancer Res | year= 1986 | volume= 46 | issue= 8 | pages= 4189-94 | pmid=3015384 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3015384  }}</ref>
* Lower socioeconomic status<ref name="pmid19096304">{{cite journal| author=Ou SH, Ziogas A, Zell JA| title=Prognostic factors for survival in extensive stage small cell lung cancer (ED-SCLC): the importance of smoking history, socioeconomic and marital statuses, and ethnicity. | journal=J Thorac Oncol | year= 2009 | volume= 4 | issue= 1 | pages= 37-43 | pmid=19096304 | doi=10.1097/JTO.0b013e31819140fb | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19096304  }}</ref>
* Hispanic and African American ethnicity<ref name="pmid19096304">{{cite journal| author=Ou SH, Ziogas A, Zell JA| title=Prognostic factors for survival in extensive stage small cell lung cancer (ED-SCLC): the importance of smoking history, socioeconomic and marital statuses, and ethnicity. | journal=J Thorac Oncol | year= 2009 | volume= 4 | issue= 1 | pages= 37-43 | pmid=19096304 | doi=10.1097/JTO.0b013e31819140fb | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19096304  }}</ref>
* Poor [[performance status]]<ref name="pmid3015384">{{cite journal| author=Osterlind K, Andersen PK| title=Prognostic factors in small cell lung cancer: multivariate model based on 778 patients treated with chemotherapy with or without irradiation. | journal=Cancer Res | year= 1986 | volume= 46 | issue= 8 | pages= 4189-94 | pmid=3015384 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3015384  }}</ref>
*[[Smoking]]
* Reduced [[hemoglobin]] and raised serum [[lactate dehydrogenase]]<ref name="pmid3015384">{{cite journal| author=Osterlind K, Andersen PK| title=Prognostic factors in small cell lung cancer: multivariate model based on 778 patients treated with chemotherapy with or without irradiation. | journal=Cancer Res | year= 1986 | volume= 46 | issue= 8 | pages= 4189-94 | pmid=3015384 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3015384  }}</ref>


==Prognosis==
===5-Year Survival===
===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.
* Between 2004 and 2010, the 5-year relative survival of patients with SCLC was 6.6%.<ref name="SEER">Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.</ref>


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:
* When stratified by age, the 5-year relative survival of patients with SCLC was 8.4% and 4.7% for patients<65 and ≥ 65 years of age respectively.<ref name="SEER">Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.</ref>


:*The stage of the cancer
* The survival of patients with SCLC varies with the stage of the disease.  Shown below is a table depicting the 5-year relative survival by the stage of SCLC:<ref name="SEER">Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.</ref>
 
:*The blood level of lactate dehydrogenase (LDH)


:*The patient’s gender and general health
{| style="cellpadding=0; cellspacing= 0; width: 600px;"
|-
| style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF; width: 10%" align="center" |'''Stage'''|| style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF; width: 10%" align="center" | '''5-year Relative Survival (%)'''
'''(2004 - 2010)'''
|-
! style="font-size: 100; padding: 0 5px; background: #DCDCDC" align="center" |'''All stages'''
| style="font-size: 100; padding: 0 5px; background: #F5F5F5" align="center" |6.3%
|-
! style="font-size: 100; padding: 0 5px; background: #DCDCDC" align="center" |'''Localized'''
| style="font-size: 100; padding: 0 5px; background: #F5F5F5" align="center" |24.2%
|-
| style="font-size: 100; padding: 0 5px; background: #DCDCDC" align="center" |'''Regional'''|| style="font-size: 100; padding: 0 5px; background: #F5F5F5" align="center" |14.3%
|-
| style="font-size: 100; padding: 0 5px; background: #DCDCDC" align="center" |'''Distant'''|| style="font-size: 100; padding: 0 5px; background: #F5F5F5" align="center" |2.8%
|-
| style="font-size: 100; padding: 0 5px; background: #DCDCDC" align="center" |'''Unstaged'''|| style="font-size: 100; padding: 0 5px; background: #F5F5F5" align="center" |7.8%
|}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Needs content]]


[[Category:Disease]]
[[Category:Disease]]
[[Category:Endocrinology]]
[[Category:Types of cancer]]
[[Category:Pulmonology]]
[[Category:Pulmonology]]
[[Category:Oncology]]
[[Category:Lung cancer]]
[[Category:Mature chapter]]


{{WikiDoc Help Menu}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
{{WikiDoc Sources}}

Latest revision as of 22:19, 3 September 2019

Small Cell Carcinoma of the Lung Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Small Cell Carcinoma of the Lung from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Radiation Therapy

Surgery

Prevention

Future or Investigational Therapies

Case Studies

Case #1

Small cell carcinoma of the lung natural history, complications and prognosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Small cell carcinoma of the lung natural history, complications and prognosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Small cell carcinoma of the lung natural history, complications and prognosis

CDC on Small cell carcinoma of the lung natural history, complications and prognosis

Small cell carcinoma of the lung natural history, complications and prognosis in the news

Blogs on Small cell carcinoma of the lung natural history, complications and prognosis

Directions to Hospitals Treating Small cell carcinoma of the lung

Risk calculators and risk factors for Small cell carcinoma of the lung natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Vendhan Ramanujam M.B.B.S [3]

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. With the current treatment modalities, the median survival of patients with limited stage disease ranges from 16 to 24 months while that of patients with extensive-stage disease ranges from 6 to 12 months. SCLC can be complicated by paraneoplastic syndromes. Limited stage disease, absence of brain metastasis, young age, and female sex are considered good prognostic factors.

Natural History, Complications, and Prognosis

Natutral History

Complications

Complications of the Disease Itself
Complications of the Treatment

Post operative complications following surgery include:[10]

Prognosis

Good Prognostic Factors

Bad Prognostic Factors

5-Year Survival

  • Between 2004 and 2010, the 5-year relative survival of patients with SCLC was 6.6%.[13]
  • When stratified by age, the 5-year relative survival of patients with SCLC was 8.4% and 4.7% for patients<65 and ≥ 65 years of age respectively.[13]
  • The survival of patients with SCLC varies with the stage of the disease. Shown below is a table depicting the 5-year relative survival by the stage of SCLC:[13]
Stage 5-year Relative Survival (%)

(2004 - 2010)

All stages 6.3%
Localized 24.2%
Regional 14.3%
Distant 2.8%
Unstaged 7.8%

References

  1. ↑ 1.0 1.1 1.2 General Information About Small Cell Lung Cancer. National cancer institute. Accessed on June 17.[1]
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 Osterlind K, Andersen PK (1986). "Prognostic factors in small cell lung cancer: multivariate model based on 778 patients treated with chemotherapy with or without irradiation". Cancer Res. 46 (8): 4189–94. PMID 3015384.
  3. ↑ 3.0 3.1 3.2 3.3 Brueckl WM, Herbst L, Lechler A, Fuchs F, Schoeberl A, Zirlik S; et al. (2006). "Predictive and prognostic factors in small cell lung carcinoma (SCLC)--analysis from routine clinical practice". Anticancer Res. 26 (6C): 4825–32. PMID 17214347.
  4. ↑ 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.
  5. ↑ 5.0 5.1 5.2 5.3 5.4 5.5 Gandhi L, Johnson BE (2006). "Paraneoplastic syndromes associated with small cell lung cancer". J Natl Compr Canc Netw. 4 (6): 631–8. PMID 16813730.
  6. ↑ Radulescu D, Pripon S, Bunea D, Ciuleanu TE, Radulescu LI (2007). "Endocrine paraneoplastic syndromes in small cell lung carcinoma. Two case reports". J BUON. 12 (3): 411–4. PMID 17918299.
  7. ↑ 7.0 7.1 Elrington GM, Murray NM, Spiro SG, Newsom-Davis J (1991). "Neurological paraneoplastic syndromes in patients with small cell lung cancer. A prospective survey of 150 patients". J Neurol Neurosurg Psychiatry. 54 (9): 764–7. PMC 1014512. PMID 1659614.
  8. ↑ 8.0 8.1 8.2 8.3 8.4 Amir J, Galbraith RC (1992). "Paraneoplastic limbic encephalopathy as a nonmetastatic complication of small cell lung cancer". South Med J. 85 (10): 1013–4. PMID 1329233.
  9. ↑ Mullans EA, Cohen PR (1996). "Tripe palms: a cutaneous paraneoplastic syndrome". South Med J. 89 (6): 626–7. PMID 8638207.
  10. ↑ Uramoto H, Nakanishi R, Fujino Y, Imoto H, Takenoyama M, Yoshimatsu T; et al. (2001). "Prediction of pulmonary complications after a lobectomy in patients with non-small cell lung cancer". Thorax. 56 (1): 59–61. PMC 1745907. PMID 11120906.
  11. ↑ 11.0 11.1 11.2 Ou SH, Ziogas A, Zell JA (2009). "Prognostic factors for survival in extensive stage small cell lung cancer (ED-SCLC): the importance of smoking history, socioeconomic and marital statuses, and ethnicity". J Thorac Oncol. 4 (1): 37–43. doi:10.1097/JTO.0b013e31819140fb. PMID 19096304.
  12. ↑ Gaspar LE, McNamara EJ, Gay EG, Putnam JB, Crawford J, Herbst RS; et al. (2012). "Small-cell lung cancer: prognostic factors and changing treatment over 15 years". Clin Lung Cancer. 13 (2): 115–22. doi:10.1016/j.cllc.2011.05.008. PMID 22000695.
  13. ↑ 13.0 13.1 13.2 Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.


Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Small_cell_carcinoma_of_the_lung_natural_history,_complications_and_prognosis&oldid=1581126"