Citation Information :
Cimen F, Aloglu M, Düzgün S, Senturk A, Atikcan S. Prognosis, Survival, and Clinicopathological Characteristics of Small Cell Lung Cancer with Pleural Fluid. Indian J Respir Care 2022; 11 (2):135-139.
Objective: While malignant pleural effusion (MPE) is generally observed in non-small cell lung cancer (SCLC) patients, its prevalence in SCLC has not been reported.
Methods: Patients over 18 who were admitted to our hospital between January 2015 and December 2019 and diagnosed with SCLC histologically were retrospectively studied. Demographic data, tumor location, tumor stage, pleural fluid characteristics, radiological findings, and overall survival were recorded from hospital records.
Results: Our study included 59 patients (48 [81.4%] men and 11 [18.6%] women), with a median age of 67. Forty-seven (79.7%) patients had a history of smoking. The patients had median tumor standardized uptake values (SUV) max levels of 11.9, a tumor diameter of 6 cm, and a follow-up period of 7 months. Protein levels in pleural fluid of the metastasizing group were significantly higher than in the nonmetastatic group (P = 0.049). In the univariate model, age, N stage, pleural fluid glucose, and pleural fluid protein levels were found significantly efficient in predicting disease-free survival (P = 0.008, P = 0.001, P = 0.001, and P = 0.026, respectively). In the multivariate reduced model, N stage, pleural fluid glucose, and pleural fluid protein levels were found independent predictive factors for disease-free survival (P = 0.000, P = 0.000, and P = 0.009, respectively).
Conclusions: MPE is common at presentation (11%) in patients with SCLC and may be associated with reduced survival. Additional studies are needed to assess the treatment-adjusted survival rate in the MPE setting.
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136:E359-86.
Govindan R, Page N, Morgensztern D, Read W, Tierney R, Vlahiotis A, et al. Changing epidemiology of small-cell lung cancer in the United States over the last 30 years: Analysis of the surveillance, epidemiologic, and end results database. J Clin Oncol 2006;24:4539-44.
Noone AM, Howlader N, Krapcho M, Miller D, Brest A, Yu M, et al., editors. SEER Cancer Statistics Review, 1975-2010. Bethesda, MD: National Cancer Institute; 2016. Available from: https://seer.cancer.gov/csr/1975_2014/. [Last accessed on 2017 Apr 13].
Riaz SP, Lüchtenborg M, Coupland VH, Spicer J, Peake MD, Møller H. Trends in incidence of small cell lung cancer and all lung cancer. Lung Cancer 2012;75:280-4.
Nicholson AG, Chansky K, Crowley J, Beyruti R, Kubota K, Turrisi A, et al. The international association for the study of lung cancer lung cancer staging project: Proposals for the revision of the clinical and pathologic staging of small cell lung cancer in the forthcoming eighth edition of the TNM classification for lung cancer. J Thorac Oncol 2016;11:300-11.
Shepherd FA, Crowley J, Van Houtte P, Postmus PE, Carney D, Chansky K, et al. The international association for the study of lung cancer lung cancer staging project: Proposals regarding the clinical staging of small cell lung cancer in the forthcoming (seventh) edition of the tumor, node, metastasis classification for lung cancer. J Thorac Oncol 2007;2:1067-77.
Ryu JS, Ryu HJ, Lee SN, Memon A, Lee SK, Nam HS, et al. Prognostic impact of minimal pleural effusion in non-small-cell lung cancer. J Clin Oncol 2014;32:960-7.
Niho S, Kubota K, Yoh K, Goto K, Ohmatsu H, Nihei K, et al. Clinical outcome of chemoradiation therapy in patients with limited-disease small cell lung cancer with ipsilateral pleural effusion. J Thorac Oncol
Porcel JM, Gasol A, Bielsa S, Civit C, Light RW, Salud A. Clinical features and survival of lung cancer patients with pleural effusions. Respirology 2015;20:654-9.
Morgensztern D, Waqar S, Subramanian J, Trinkaus K, Govindan R. Prognostic impact of malignant pleural effusion at presentation in patients with metastatic non-small-cell lung cancer. J Thorac Oncol
Antunes G, Neville E, Duffy J, Ali N; Pleural Diseases Group; Standards of Care Committee, British Thoracic Society. BTS guidelines for the management of malignant pleural effusions. Thorax
Brun C, Gay P, Cottier M, Karpathiou G, Patoir A, Tiffet O, et al. Comparison of cytology, chest computed and positron emission tomography findings in malignant pleural effusion from lung cancer. J Thorac Dis 2018;10:6903-11.
Ko J, Winslow MM, Sage J. Mechanisms of small cell lung cancer metastasis. EMBO Mol Med 2021;13:e13122.
Shojaee S, Singh I, Solsky I, Nana-Sinkam P. Malignant pleural effusion at presentation in patients with small-cell lung cancer. Respiration
Zamboni MM, da Silva CT Jr., Baretta R, Cunha ET, Cardoso GP. Important prognostic factors for survival in patients with malignant pleural effusion. BMC Pulm Med 2015;15:29.
Lim JH, Ryu JS, Kim JH, Kim HJ, Lee D. Gender as an independent prognostic factor in small-cell lung cancer: Inha lung cancer cohort study using propensity score matching. PLoS One 2018;13:e0208492.
Videtic GM, Stitt LW, Dar AR, Kocha WI, Tomiak AT, Truong PT, et al. Continued cigarette smoking by patients receiving concurrent chemoradiotherapy for limited-stage small-cell lung cancer is associated with decreased survival. J Clin Oncol 2003;21:1544-9.