Small-cell carcinoma of the lung—survival according to histologic subtype: A veterans administration lung group study

Abstract
Six‐hundred‐twenty cases of small‐cell carcinoma of the lung entered into the Veterans Administration Lung Group protocols 9–15 were retrospectively subdivided into histologic subtype, as proposed by the WHO (1977). Medium survival was greater for subtype No. 21 (lymphocyte‐like) than for subtype No. 22 (intermediate) (17.2 vs. 12.6 weeks; P = 0.005). Patients with extensive disease survived longer with subtype No. 21 than subtype No. 22 (14.5 vs. 10.9 weeks; P = 0.026). However, no median survival difference was seen with limited disease. Survival for subtype 21 was greater than No. 22 (P = 0.016) for patients with poor initial performance status (IPS; Karnofsky 70 or less); for ambulatory patients (IPS 80‐100) a survival advantage was seen for subtype No. 21 compared with No. 22, but did not quite reach statistical significance (P = 0.09). Survival in subtype No. 21 was better than in subtype No. 22 (24.3 vs. 14.7 weeks; P = 0.001) when no weight loss (less than 10 pounds over the six‐month period prior to therapy) was documented. However, with weight loss (greater than 10 pounds) survival in each subtype was similar.