Prognostic significance of eighth edition TNM stage criteria in combined small-cell lung cancer

Ziran Zhao; Yibo Gao; Fengwei Tan; Qi Xue; Shugeng Gao; Jie He

doi:10.3389/fonc.2023.1018288

Prognostic significance of eighth edition TNM stage criteria in combined small-cell lung cancer

Front Oncol. 2023 Mar 8:13:1018288. doi: 10.3389/fonc.2023.1018288. eCollection 2023.

Authors

Ziran Zhao¹, Yibo Gao¹, Fengwei Tan¹, Qi Xue¹, Shugeng Gao¹, Jie He¹

Affiliation

¹ Thoracic Surgery Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Abstract

Objectives: This study aimed to evaluate the prognostic significance of the eighth edition TNM stage criteria in patients with combined small-cell lung cancer (C-SCLC) on a population level.

Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, patients diagnosed with C-SCLC (histology code 8245) between the years 2004 and 2015 were identified. We performed a Kaplan-Meier analysis and used the multivariable cox regression proportional hazards model to obtain prognostic overall survival estimates for each group of patients.

Results: A total of 477 patients diagnosed with C-SCLC were identified. The T, N, M, TNM, and combined TNM stage status of the eighth edition were all significant prognostic factors for patients' overall survivals, with the best discrimination identified in the combined stages. Surgery was also found to be a prognostic factor (HR =1.95, 95%CI =1.49-2.56, p<0.01) for patients with C-SCLC.

Conclusions: The combined eighth edition of the TNM staging criteria shows reliable prognostic significance in patients with C-SCLC. Moreover, surgery might be significant for improving the patients' prognosis.

Keywords: 8th TNM stage criteria; SEER database; combined small cell lung cancer (c-SCLC); prognostic significance; surgery.

Grants and funding

This work was supported by the National Key R&D Program of China (2020AAA0109500), National Natural Science Foundation of China (82122053), the Beijing Municipal Science & Technology Commission (Z191100006619118), R&D Program of Beijing Municipal Education Commission (KJZD20191002302), CAMS Initiative for Innovative Medicine (2021-1-I2M-012, 2021-1-I2M-015), Key-Area Research and Development Program of Guangdong Province (2021B0101420005), Shenzhen High-level Hospital Construction Fund, and Sanming Project of Medicine in Shenzhen.