LONG-TERM SURVIVAL IN SMALL-CELL LUNG-CANCER - POSTTREATMENT CHARACTERISTICS IN PATIENTS SURVIVING 5 TO 18- AN ANALYSIS OF 1,714 CONSECUTIVE PATIENTS( YEARS )

Purpose: To describe in patients with small-cell lung cancer (SCLC) th e characteristics of those who survive for greater than or equal to 5 years, to identify long-term prognostic factors, to analyze survival d ata of 5-year survivors, and to study 10-year survival in patients ent ered before 1981. Patients and Methods: A total 1,714 unselected patie nts with SCLC were treated with combination chemotherapy in nine conse cutive clinical trials from 1973 to 1991. All medical records were rev iewed and follow-up data obtained to analyze and compare pretreatment and posttreatment characteristics. Results: Sixty patients survived lo nger than 5 years, Late relapses occurred in 15.0% of 5-year survivors and secondary malignancies in 20.0%. Twenty-six patients are still al ive and disease-free 5 to 18 years (median, 9.5 years) from initiation of treatment. Extensive-stage disease, performance status (PS) more t han 2, liver and bone marrow metastases, and elevated lactate dehydrog enase (LDH) and alkaline phosphatase levels were all negative prognost ic factors. The 5-year survival rate was 3.5% (limited-stage disease, 4.8%; extensive-stage disease, 2.3%), and the 10-year survival rate wa s 1.8% (limited-stage disease, 2.5%; extensive-stage disease, 1.2%). C onclusion: Long-term survival can be achieved for both stages of SCLC, but without any change in survival rates over the last decade, Long-t erm survivors continuously seem to have considerable mortality due to late relapses and secondary malignancies, especially tobacco-related c ancers and other tobacco-related diseases. (C) 1995 by American Societ y of Clinical Oncology.