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Background <p>The optimal surgical extent for early-stage small-cell lung cancer (SCLC) remains undefined.</p> Methods <p>Using the SEER database (2004–2019), we identified 560 patients with pathologic stage I (pT1-T2aN0M0) SCLC who underwent resection. To compare overall (OS) and lung cancer-specific survival (LCSS) between lobectomy (L) and sublobar resection (Sub-L), we constructed a propensity score-matched (PSM) cohort of 130 patient pairs.</p> Outcomes <p>In the overall cohort (n = 560), unadjusted 5-year OS favored L (52.2% vs. 37.8%, p &lt; 0.001). After matching, L remained associated with superior OS (5-year: 54.3% vs. 37.9%, p = 0.025) but LCSS was comparable between groups before or after PSM (5-year LCSD: 36.5% vs. 43.0%, p = 0.088; 34.5% vs. 39.1%, p = 0.444, respectively). Multivariate Cox regression (HR: 0.65, 95% CI 0.50–0.85, p = 0.002) and competing risk regression (sHR: 0.76, 95% CI 0.57–1.02, p = 0.07) corroborated these findings. Subgroup analysis indicated that L was associated with improved OS and reduced LCSD in patients with pure SCLC.</p> Conclusion <p>In this population-based analysis, Sub-L offered comparable lung cancer-specific survival to L in stage I SCLC. These findings suggest that Sub-L, particularly for tumors ≤ 2&#xa0;cm, may be an appropriate alternative for carefully selected patients within a multimodality treatment pathway. Prospective studies are warranted to confirm these results.</p>

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Impact of surgical approach on stage I small cell lung cancer according to the eighth edition of TNM classification: a population-based study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月30日

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  • Bin Wang,
  • Jian Zhang,
  • Jian Sun,
  • Ji Li,
  • Wenxiao Jia,
  • Hui Zhu,
  • Hongbo Guo,
  • Xuzheng Zhang,
  • Xiaokang Guo

摘要

Background

The optimal surgical extent for early-stage small-cell lung cancer (SCLC) remains undefined.

Methods

Using the SEER database (2004–2019), we identified 560 patients with pathologic stage I (pT1-T2aN0M0) SCLC who underwent resection. To compare overall (OS) and lung cancer-specific survival (LCSS) between lobectomy (L) and sublobar resection (Sub-L), we constructed a propensity score-matched (PSM) cohort of 130 patient pairs.

Outcomes

In the overall cohort (n = 560), unadjusted 5-year OS favored L (52.2% vs. 37.8%, p < 0.001). After matching, L remained associated with superior OS (5-year: 54.3% vs. 37.9%, p = 0.025) but LCSS was comparable between groups before or after PSM (5-year LCSD: 36.5% vs. 43.0%, p = 0.088; 34.5% vs. 39.1%, p = 0.444, respectively). Multivariate Cox regression (HR: 0.65, 95% CI 0.50–0.85, p = 0.002) and competing risk regression (sHR: 0.76, 95% CI 0.57–1.02, p = 0.07) corroborated these findings. Subgroup analysis indicated that L was associated with improved OS and reduced LCSD in patients with pure SCLC.

Conclusion

In this population-based analysis, Sub-L offered comparable lung cancer-specific survival to L in stage I SCLC. These findings suggest that Sub-L, particularly for tumors ≤ 2 cm, may be an appropriate alternative for carefully selected patients within a multimodality treatment pathway. Prospective studies are warranted to confirm these results.