Small-cell carcinoma of the lung detected by CT screening: Stage distribution and curability

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• 作者：John H.M. Austin^a ; Rowena Yip^b ; Belinda M. D'Souza^a ; David F. Yankelevitz^b ; Claudia I. Henschke^b ; ^c ; ^{Claudia.Henschke@mountsinai.org} ; for the International Early Lung Cancer Action Program Investigators
• 关键词：CT ; Lung cancer ; Lung neoplasm ; Screening ; Small-cell carcinoma
• 刊名：Lung Cancer
• 出版年：2012
• 期刊代码：187_01695002
• 类别：med
• 出版时间：June, 2012
• 卷：76
• 期：3
• 页码：339-343
• 文件大小：266 K

摘要

Background

Prognosis is incompletely known for small-cell lung carcinoma (SCLC) detected by CT screening of at-risk subjects.

Methods

A multinational study of baseline and annual repeat CT screening for lung cancer of 48,037 at-risk subjects yielded 48 persons (median age 68 years) with SCLC. Stage (tumor, node, metastasis system) distribution and death rates were compared with those of 7960 usual-care SCLC subjects (chi-square or Fisher exact testing, as appropriate), as reported by the International Association for the Study of Lung Cancer. Cure was estimated by Kaplan-Meier analysis.

Results

Forty-four (92%) of the patients were asymptomatic at screening CT detection of their SCLC; four (8%) presented with cancer-related symptoms before the next scheduled repeat screening. SCLC was diagnosed in clinical stages IA and IV in 16 (33%) and 7 (15%), respectively, of 48 patients, compared to 211 (3%) and 4530 (57%), respectively, of the 7960 patients in the usual-care study (P < 0.0001). Tumor diameter was 鈮?.0 cm for each of the 16 subjects in clinical stage I. The percentage of clinical stage I SCLC-related deaths within 5 years was lower in the screening study than in the usual-care study (44%vs. 71%, P = 0.03), as was also the percentage of advanced stage (IIIB plus IV) SCLC-related deaths (62%vs. 94%, P < 0.0001).

Conclusions

Compared to usual-care detection of SCLC, CT screening identified a shift toward early stage and away from late stage disease, and was associated with a decrease in deaths from the disease.