Association of Race, Socioeconomic Factors, and Treatment Characteristics With Overall Survival in Patients With Limited-Stage Small Cell Lung Cancer

• Published in: JAMA network open 2021-01, Vol.4 (1), p.e2032276-e2032276
• Main Authors: Zhou, Kexun, Shi, Huashan, Chen, Ruqin, Cochuyt, Jordan J, Hodge, David O, Manochakian, Rami, Zhao, Yujie, Ailawadhi, Sikander, Lou, Yanyan
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Female; Humans; Lung cancer; Lung Neoplasms - ethnology; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Male; Middle Aged; Neoplasm Staging; Oncology; Online Only; Original Investigation; Race; Race Factors; Small Cell Lung Carcinoma - ethnology; Small Cell Lung Carcinoma - mortality; Small Cell Lung Carcinoma - pathology; Social Class; Socioeconomic factors; Survival Analysis; United States
• ISSN: 2574-3805; 2574-3805
• DOI: 10.1001/jamanetworkopen.2020.32276

It has been established that disparities in race and socioeconomic status are associated with outcomes of non-small cell lung cancer. However, it remains unknown whether this extends to stage I, II, or III small cell lung cancer (SCLC), or limited-stage SCLC (L-SCLC). To investigate the associations of race, socioeconomic factors, and treatment characteristics with survival among patients with L-SCLC. Demographic information for patients with L-SCLC diagnosed between 2004 and 2014 was obtained from the National Cancer Database. The follow-up end point is death or last follow-up (date of last contact). Patients were divided into 5 mutually exclusive cohorts by race. Data analysis was performed in October 2019. Cox proportional hazards models were used to calculate univariable and multivariable models. Multivariable analyses were conducted to assess the associations of race and socioeconomic factors with risk-adjusted outcomes. Overall survival between groups was depicted by Kaplan-Meier curves. Of 72 409 patients analyzed (median [range] age, 67.0 [23.0-90.0] years), 40 289 (55.6%) were women. The distribution of disease stage was 10 619 patients (14.7%) with stage I disease, 7689 patients (10.6%) with stage II disease, and 54 101 patients (74.7%) with stage III disease. The median (range) duration of follow-up was 8.2 (2.4-15.8) months. Compared with White patients, the hazard of death decreased to 0.92 (95% CI, 0.89-0.95; P