Small Cell Lung Cancer and Pleural Effusion: An Analysis from a District General Hospital.

IF 2.3 Q2 RESPIRATORY SYSTEM Pulmonary Therapy Pub Date : 2023-09-01 Epub Date: 2023-06-06 DOI:10.1007/s41030-023-00228-w

Nathaniel Keidan, Avinash Aujayeb

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引用次数: 1

Abstract

Introduction: The incidence of malignant pleural effusion (MPE) in patients with small cell lung cancer (SCLC) in an American population is approximately 11%, and overall survival in that group is 3 months (compared to 7 months without an effusion. To our knowledge, no study has been done in the United Kindgom and we thus sought to determine the characteristics of the local population.

Method: All patients coded as having small cell lung cancer from Somerset register from January 2012-September 2021 were reviewed. We excluded those with indeterminate pathology reports, carcinoid or large cell neuroendocrine cancers. Basic demographics, presence of an MPE and any interventions and outcomes were collected for descriptive analysis. Continuous variables are presented as mean (±) range, median (± IQR) when outliers were present and categorical variables as percentages where appropriate. Caldicott reference C3905.

Results: Four hundred one patients with SCLC were identified (11% of all patients, median time to death from presentation 208 days, IQR 304 [many outliers); 224 (55.9%) were female, 177 male [median age 75 years, IQR 13]. One hundred seven (27%) presented with an effusion: 23 were sampled, 10 had positive cytology, all were exudates, 8 required chest drainage, the mean performance status (PS) was 2 (range 1-4) and the median time to death 142 days, IQR 45. Of the 294 with no initial effusions, 70 (24%) developed a pleural effusion with progressive disease (mean PS 1, median age 71.5 years, IQR 14, median to death 327 days, IQR 395, 1 outlier); 224 patients never had a MPE with a median time to death of 212 days, IQR 305, multiple outliers and, when compared to those with a MPE at any point, median time to death was 211 days, IQR 295.5 (multiple outliers).

Conclusion: Meaningful analysis was difficult because of the presence of multiple outliers in values collected and not correcting for stage at presentation or treatment modalities and previous studies did not correct for those either. Those presenting with an MPE had a poorer prognosis, probably signifying advanced disease and the presence of MPE in our SCLC cohort seems higher. Large prospective databases for this are required.

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小细胞肺癌与胸腔积液：一家地区综合医院的分析

简介：在美国人群中，小细胞肺癌（SCLC）患者恶性胸腔积液（MPE）的发病率约为 11%，该群体的总生存期为 3 个月（相比之下，无积液患者的总生存期为 7 个月）。据我们所知，英国尚未进行过此类研究，因此我们试图确定当地人群的特征：方法：我们回顾了萨默塞特登记处 2012 年 1 月至 2021 年 9 月期间所有被编码为小细胞肺癌的患者。我们排除了病理报告不确定、类癌或大细胞神经内分泌癌患者。我们收集了基本人口统计学数据、是否存在 MPE 以及任何干预措施和结果，以进行描述性分析。连续变量以平均值（±）范围、中位数（± IQR）（如出现异常值）表示，分类变量则酌情以百分比表示。结果：共发现 401 名 SCLC 患者（占所有患者的 11%，从发病到死亡的中位时间为 208 天，IQR 为 304 天[许多异常值]）；其中 224 名（55.9%）为女性，177 名为男性[中位年龄为 75 岁，IQR 为 13]。177例（27%）患者出现渗出：23例采样，10例细胞学检查呈阳性，全部为渗出物，8例需要胸腔引流，平均表现状态（PS）为2（范围1-4），中位死亡时间为142天，IQR为45。在最初没有积液的 294 例患者中，70 例（24%）出现胸腔积液并伴有疾病进展（平均 PS 1，中位年龄 71.5 岁，IQR 14，中位死亡时间 327 天，IQR 395，1 个离群值）；224 例患者从未出现 MPE，中位死亡时间为 212 天，IQR 305，多个离群值，与任何时候出现 MPE 的患者相比，中位死亡时间为 211 天，IQR 295.5（多个离群值）：由于收集的数值存在多个离群值，且未对发病分期或治疗方式进行校正，因此很难进行有意义的分析，而之前的研究也未对这些离群值进行校正。出现 MPE 的患者预后较差，这可能意味着疾病处于晚期，而我们的 SCLC 队列中出现 MPE 的比例似乎更高。这需要大型前瞻性数据库的支持。

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来源期刊

Pulmonary Therapy Medicine-Pulmonary and Respiratory Medicine

CiteScore

5.20

自引率

3.30%

发文量

审稿时长

6 weeks

期刊介绍： Aims and Scope Pulmonary Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from pre-clinical, clinical (all phases), observational, real-world, and health outcomes research around the use of pulmonary therapies, devices, and surgical techniques. Areas of focus include, but are not limited to: asthma; chronic obstructive pulmonary disease; idiopathic pulmonary fibrosis; pulmonary hypertension; cystic fibrosis; lung cancer; respiratory tract disorders; allergic rhinitis and other respiratory allergies; influenza, pneumococcal infection, respiratory syncytial virus and other respiratory infections; and inhalers and other device therapies. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Pulmonary Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. Rapid Publication The journal’s publication timelines aim for a rapid peer review of 2 weeks. If an article is accepted it will be published 3–4 weeks from acceptance. The rapid timelines are achieved through the combination of a dedicated in-house editorial team, who manage article workflow, and an extensive Editorial and Advisory Board who assist with peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid, efficient communication of the latest research and reviews, fostering the advancement of pulmonary therapies. Open Access All articles published by Pulmonary Therapy are open access. Personal Service The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning authors will always have an editorial contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE, GPP and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research. 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Our editorial team are able to create high-quality slide decks and infographics in-house, and video abstracts through our partner Research Square, and would be happy to assist in any way we can. For further information about digital features, please contact the journal editor (see ‘Contact the Journal’ for email address), and see the ‘Guidelines for digital features and plain language summaries’ document under ‘Submission guidelines’. For examples of digital features please visit our showcase page https://springerhealthcare.com/expertise/publishing-digital-features/ Publication Fees Upon acceptance of an article, authors will be required to pay the mandatory Rapid Service Fee of €4500/ $5100/ £3650. The journal will consider fee discounts and waivers for developing countries and this is decided on a case by case basis. Peer Review Process Upon submission, manuscripts are assessed by the editorial team to ensure they fit within the aims and scope of the journal and are also checked for plagiarism. All suitable submissions are then subject to a comprehensive single-blind peer review. Reviewers are selected based on their relevant expertise and publication history in the subject area. The journal has an extensive pool of editorial and advisory board members who have been selected to assist with peer review based on the afore-mentioned criteria. At least two extensive reviews are required to make the editorial decision, with the exception of some article types such as Commentaries, Editorials, and Letters which are generally reviewed by one member of the Editorial Board. Where reviewer recommendations are conflicted, the editorial board will be contacted for further advice and a presiding decision. Manuscripts are then either accepted, rejected or authors are required to make major or minor revisions (both reviewer comments and editorial comments may need to be addressed). Once a revised manuscript is re-submitted, it is assessed along with the responses to reviewer comments and if it has been adequately revised it will be accepted for publication. Accepted manuscripts are then copyedited and typeset by the production team before online publication. Appeals against decisions following peer review are considered on a case-by-case basis and should be sent to the journal editor. Preprints We encourage posting of preprints of primary research manuscripts on preprint servers, authors’ or institutional websites, and open communications between researchers whether on community preprint servers or preprint commenting platforms. Posting of preprints is not considered prior publication and will not jeopardize consideration in our journals. 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