Prognostic significance of supraclavicular lymph nodes in small cell lung cancer - A study from four consecutive clinical trials, including 1,370 patients

Study objective: To determine the prognostic significance of supraclavicula r lymph node (SCLN) involvement in small cell lung cancer, Materials and methods: Patients (1,370) with small cell lung cancer were in cluded in four consecutive clinical trials and classified as having either limited or extensive forms of disease using the Veterans Administration sta ging system. Results: SCLN was present in 17% of patients (n = 234). Median survival was 258 days for patients with SCLN (n = 234) and 297 days for patients withou t SCLN (n = 1136) (p = 0.002), SCLN involvement was correlated with the pre sence of distant metastases at baseline (169 vs 65, p = < 0.001). Median su rvival was 375 clays for patients with limited forms without SCLN (n = 529) , 332 days for those with limited forms with SCLN (n = 65) (p = 0.12), 244 days for those with extensive forms without SCLN (n = 604), and 228 days fo r those with extensive forms with SCLN (n = 169) (p = 0.94). The e-year sur vival rates were 17%, 12%, 2%, and 4%, respectively, Cox: models confirmed that SCLN did not provide any significant additional prognostic information . Conclusion: SCLN is highly correlated with extensive forms explaining its o verall prognostic value, In limited disease, SCLN is only a minor poor prog nostic factor, not justifying any amendment to the staging system currently used.