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Disparities in the Management of Patients With Stage I Small Cell Lung Carcinoma (SCLC): A Surveillance, Epidemiology and End Results (SEER) Analysis
- Source :
- Clinical Lung Cancer. 18:e315-e325
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- Patients with stage I small cell lung carcinoma (SCLC) are candidates for surgery; however, not much is known regarding the utilization of surgical resection in the management of stage I SCLC and the factors that determine the patient's ability to receive surgery.The Surveillance, Epidemiology and End Results database was used to identify patients with stage I SCLC from 2007 to 2013. Continuous variables were compared with 1-way analysis of variance, and categorical variables were compared with χOf the 1902 patients with stage I SCLC, 427 (22.4%) underwent resection, 116 (6.1%) resection and radiation, 815 (42.8%) received radiation alone, and 544 (28.6%) did not undergo surgery or radiation. Median overall survival for patients with surgery plus radiation was 60+ months, followed by surgery alone at 50 months, radiation at 27 months, and no resection/radiation 16 months. Patients with ≥ 4 lymph nodes removed during surgery had better overall survival of 60+ months compared with patients with 4 lymph nodes removed (25 months); P .001. Multivariate analysis demonstrated that elderly patients, men, African American individuals, Medicaid recipients, and patients with left-sided tumors were less likely to undergo resection. However, county-level socioeconomic factors, such as level of poverty, education, unemployment, and median income did not affect the likelihood of undergoing resection.Fewer than one-third of all patients with stage I SCLC undergo resection despite better outcomes with resection. Elderly African American men with Medicaid insurance were less likely to receive resection.
- Subjects :
- Male
Pulmonary and Respiratory Medicine
Cancer Research
medicine.medical_specialty
Lung Neoplasms
medicine.medical_treatment
030204 cardiovascular system & hematology
03 medical and health sciences
Pneumonectomy
Sex Factors
0302 clinical medicine
Epidemiology
medicine
Surveillance, Epidemiology, and End Results
Humans
Healthcare Disparities
Lung cancer
Survival rate
Aged
Neoplasm Staging
Aged, 80 and over
Chemotherapy
Medicaid
business.industry
Age Factors
Odds ratio
Middle Aged
medicine.disease
Small Cell Lung Carcinoma
United States
Surgery
Black or African American
Survival Rate
Radiation therapy
Oncology
030220 oncology & carcinogenesis
Lymph Node Excision
Female
Radiotherapy, Adjuvant
business
SEER Program
Subjects
Details
- ISSN :
- 15257304
- Volume :
- 18
- Database :
- OpenAIRE
- Journal :
- Clinical Lung Cancer
- Accession number :
- edsair.doi.dedup.....590ef4ad65993865187ce38876d18159