Demographic variations, survival patterns, and mortality determinants in small-cell lung carcinoma.

Abstract

e20118 Background: Small cell lung carcinoma (SCLC) accounts for 14% of all lung cancer cases and is associated with severe morbidity and mortality, particularly among men. Despite treatment advancements, survival outcomes remain poor. Understanding demographic influences on survival and mortality can provide valuable insights into treatment efficacy and disparities. Methods: Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database for the years 2000 to 2021 via SEER*Stat 8.4.4, identifying patients by histology code 8041/3 (ICD-O-3). Demographics included sex, race, location, and year of diagnosis; pathological factors covered vital status, survival months, and chemotherapy. Patients were categorized as young (<45), middle-aged (45-64), or elderly (>65). Statistical analysis was performed in R 4.0.5. Kaplan-Meier and Cox proportional hazards models were used to evaluate survival outcomes and mortality predictors. A P-value < 0.05 was considered significant. Results: A total of 103,025 SCLC patients were identified, with older adults (n=61,578; 59.8%), White individuals (n=84,213; 81.7%), metropolitan residents (n=82,236; 79.8%), and males (n=52,216; 50.7%) being predominant. Chemotherapy was administered to 67.5% (n=69,534) of patients. Younger patients had better survival rates (48.8% [95% CI: 46.6–51.1] at one year; 18.7% [95% CI: 17.0–20.6] at five years) compared to elderly patients (25.3% [95% CI: 25.0–25.7] and 5.0% [95% CI: 4.8–5.1], respectively; p < 0.001). Females had better survival than males (p < 0.001). Asians had the highest five-year survival (8.7% [95% CI: 7.8–9.7]), followed by Black (7.1% [95% CI: 6.6–7.8]) and White (6.5% [95% CI: 6.3–6.7]) patients. Metropolitan residents had slightly better survival than non-metropolitan ones (p = 0.0029). Chemotherapy improved five-year survival to 8.6% [95% CI: 8.4–8.9], compared to 2.8% [95% CI: 2.6–3.0] in untreated patients. Cox regression identified age, sex, race, location, and chemotherapy as mortality predictors. Conclusions: Despite treatment progress, SCLC remains highly fatal, with significant survival disparities. Younger age and chemotherapy were linked to lower mortality, while older age, male sex, Black and White race, and non-metropolitan residence were associated with higher mortality risks. Tailored interventions and equitable healthcare access are needed to improve survival outcomes.