Abstract
Background
Nowadays, the characteristics and treatment of combined small-cell lung carcinoma (CSCLC) remain controversial. This study aimed to analyze the feature of clinical characteristics, survival outcomes and treatment modalities among IV CSCLC, IV SCLC and IV NSCLC, to provide more evidence for the study of IV CSCLC
Methods
All CSCLC, SCLC and NSCLC patient data were obtained from the SEER database (2010–2020). Pearson's χ2 test was used to compare the differences in clinical characteristics. Propensity score matching (PSM) was utilized to balance the bias of the variables between patients. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify prognostic factors. KM analysis was used to calculate survival.
Results
A total of 493 patients with IV CSCLC, 35503 patients with SCLC, 122807 patients with IV NSCLC were included in this study. The demographic characteristics and tumor characteristics of three groups were different. Before PSM, there were significant difference in OS and CSS among IV CSCLC, IV SCLC and IV NSCLC, After PSM, there was significant difference in OS and CSS between the IV CSCLC and IV NSCLC. Risk/protective factors for OS and CSS were different in three groups. Chemotherapy, radiotherapy, surgery all can improve survival time of IV CSCLC. Chemotherapy combine surgery can significantly improve OS and CSS in patients with IV CSCLC (10.0 months and 16.0 months), chemotherapy alone was also a good choice for some IV CSCLC patients who have already lost the opportunity for surgery at the time of first diagnosis.
Conclusions
These results indicated that the prognosis and clinical characteristics IV CSCLC, IV SCLC and IV NSCLC were significant difference. Surgery combined chemotherapy was the best treatment in patients with IV CSCLC and chemotherapy alone was a good choice for patients who have lost the indication of surgery.