Prognostic factors for survival in extensive stage small cell lung cancer (ED-SCLC): the importance of smoking history, socioeconomic and marital statuses, and ethnicity

J Thorac Oncol. 2009 Jan;4(1):37-43. doi: 10.1097/JTO.0b013e31819140fb.


Background: : We investigated whether independent prognostic factors for overall survival (OS) in non-small cell lung cancer such as ethnicity, smoking history, socioeconomic, and marital statuses are also applicable to extensive stage small cell lung cancer (ED-SCLC).

Methods: : SCLC patients diagnosed from 1991 to 2005 from 3 Southern California counties were identified. Prognostic factors for ED-SCLC patients were evaluated by univariate and multivariate analysis.

Results: : Of the 4782 SCLC patients analyzed, only 2.5% of the patients were never-smokers and 71.7% of patients presented with ED-SCLC. By multivariate analysis, a positive smoking status was a statistically significant poor prognostic factor for OS in ED-SCLC patients (versus never-smoker; hazard ratio [HR] = 1.310; p = 0.0125), in addition low socioeconomic status (SES) (from the lowest to the highest SES score; ptrend = 0.0128) and being unmarried (versus married; HR = 1.179; p < 0.0001). Asian ethnicity was a favorable prognostic factor in ED-SCLC (versus Caucasian; HR = 0.785; p = 0.0076). Female gender was another independent favorable prognostic factor (versus male; HR = 0.823; p < 0.0001).

Conclusions: : A positive history of smoking, low SES, and being unmarried are independent unfavorable prognostic factors for OS in ED-SCLC while Asian ethnicity and female gender are independent favorable prognostic factors for OS in ED-SCLC by multivariate analysis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Ethnic Groups*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Lung Neoplasms / mortality*
  • Lung Neoplasms / pathology
  • Male
  • Marital Status*
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Small Cell Lung Carcinoma / mortality*
  • Small Cell Lung Carcinoma / pathology
  • Smoking / epidemiology*
  • Social Class*
  • Survival Rate
  • Young Adult