Small Cell Lung Cancer in Norway: Patterns of Care by Health Region and Survival Trends

Yngvar Nilssen; Odd Terje Brustugun; Lars Fjellbirkeland; Bjørn Henning Grønberg; Per Magnus Haram; Nina Helbekkmo; Åslaug Helland; Sissel Gyrid Freim Wahl; Marianne Aanerud; Steinar Solberg

doi:10.1016/j.cllc.2024.04.002

Small Cell Lung Cancer in Norway: Patterns of Care by Health Region and Survival Trends

Clin Lung Cancer. 2024 Apr 10:S1525-7304(24)00046-9. doi: 10.1016/j.cllc.2024.04.002. Online ahead of print.

Affiliations

¹ Department of Registration, Cancer Registry of Norway, Oslo, Norway.
² Section of Oncology, Vestre Viken Hospital Trust, Drammen, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
³ Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Respiratory Medicine, Rikshospitalet, Oslo University Hospital, Oslo, Norway.
⁴ Department of Oncology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
⁵ Department of Cardiothoracic Surgery, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
⁶ Department of Pulmonology, University Hospital of North Norway, Tromsø, Norway.
⁷ Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Oncology, Oslo University Hospital, Oslo, Norway.
⁸ Department of Pathology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
⁹ Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway.
¹⁰ Department of Registration, Cancer Registry of Norway, Oslo, Norway; Department of Cardiothoracic Surgery, Rikshospitalet, Oslo University Hospital, Oslo, Norway. Electronic address: stsg@kreftregisteret.no.

PMID: 38692990
DOI: 10.1016/j.cllc.2024.04.002

Abstract

Introduction/background: There has been a marked survival improvement for patients with non-small-cell lung cancer. We describe the national trends in characteristics and survival, and geographical differences in diagnostic workup, treatment, and survival for patients with small-cell lung cancer (SCLC).

Materials and methods: Patients registered with SCLC at the Cancer Registry of Norway in 2002 to 2022 were included. Trends in overall survival were estimated for all SCLC patients, patients with limited stage SCLC, patients undergoing surgery, and by health region. Adjusting for case-mix, a multivariable Cox regression was performed examining the association between health region and death.

Results: The study included 8374 patients. The stage distribution remained unchanged during the study period. The 5-year overall survival increased from 7.7% to 22.8% for patients with limited stage. The use of multidisciplinary team meetings varied from 62.5% to 85.7%, and the use of positron emission tomography-computer tomography varied from 70.4% to 86.2% between the health regions. Treatment patterns differed markedly between the health regions, with the proportion dying without any registered treatment ranging from 1.2% to 10.9%. For limited stage patients in 2018 to 2022, the median overall survival ranged from 16.5 to 25.5 months across health regions, and the 5-year overall survival ranged from 18.7% to 28.7% (P = .019).

Conclusion: The survival for patients with SCLC remains poor. The use of diagnostic procedures, treatment modalities, and survival differed between regions, warranting investigations to further explore the reasons.

Keywords: Epidemiology; Oncology; Outcome; Regional disparities; Surgery.