• Vol. 36 No. 3, 181–188
  • 15 March 2007

Survival of Small-cell Lung Cancer and its Determinants of Outcome in Singapore



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Introduction: The survival and epidemiology of small-cell lung cancer (SCLC) in Singapore has not been described. We aim to present the characteristics as well as determine the survival outcome and important prognostic factors for SCLC patients. Materials and Methods: A retrospective analysis of SCLC patients diagnosed from 1999 to 2002 was conducted at the Outram campus, Singapore. Clinical characteristics and treatment data were obtained from case records and survival data were checked with the registry of births and deaths on 30 May 2005. Results: One hundred and eleven patients were analysed. There were 38 (34.2%) limited-disease (LD) patients and 73 (65.8%) extensive-disease (ED) patients. The majority were current or former smokers (94.7% among LD and 94.5% among ED). More patients with LD had good performance status (92% versus 63%, P = 0.0003) and were treated with combined chemotherapy and radiotherapy (82% versus 48%, P = 0.012). The median survival time of LD patients treated with curative chemoradiotherapy was 14.2 months (95% CI, 10.96 to 17.44). Those given prophylactic cranial irradiation had a median survival time of 16.9 months (95% CI, 11.83 to 21.97). For ED patients, the median survival time was 8.17 months (95%CI, 5.44 to 10.89). None of the factors analysed were significant prognostic factors for LD patients while performance status and type of treatment given were significant among ED patients. Conclusions: We found that the characteristics and survival of SCLC patients in Singapore are fairly similar to that of other countries.

Lung cancer is the leading cause of cancer mortality around the world.1 Small-cell lung cancer (SCLC) constitutes about 15% to 25% of all lung cancer cases in North America and Europe.2,3 In contrast, SCLC constitutes a smaller percentage of lung cancer cases in Asian countries. In a Taiwanese hospital, 8.1% of lung cancer cases seen were SCLC4 while in Singapore, the percentage of SCLC among all lung cancer cases diagnosed from 1998 to 2002 was 10.8%.5 The lower incidence of SCLC in some Asian countries probably reflects the lower smoking rates among these populations as SCLC occurs almost exclusively in smokers.

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