What is the prevalence and prognosis of small cell lung cancer (SCLC)?

Updated: Sep 12, 2019
  • Author: Abid Irshad, MD; Chief Editor: Eugene C Lin, MD  more...
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Answer

Small cell lung cancer (SCLC) accounts for approximately 13-15% of all cases of lung cancer. It once accounted for 20-25% of all newly diagnosed lung cancers. SCLC, previously known as oat cell carcinoma, is considered distinct from other lung cancers, which are called non–small cell lung cancers (NSCLCs) because of their clinical and biologic characteristics. SCLC is an aggressive form of primary pulmonary neuroendocrine tumor with short doubling time and a tendency for early metastasis. Median overall survival (OS) is about 12 months, and the median survival without treatment is 2-4 months. SCLC is divided into 2 stages: limited disease (LD) and extensive disease (ED). LD-SCLC is diagnosed in about 30% of patients and is confined to one hemithorax encompassed in a radiation port. ED-SCLC affects the remaining 70% of patients and extends beyond a single radiation field. [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13]

(Examples of SCLC are presented in the images below.)

Lung cancer, small cell. Contrast-enhanced CT scan Lung cancer, small cell. Contrast-enhanced CT scan of the chest shows a large left lung and a hilar mass, with invasion of the left pulmonary artery.
Lung cancer, small cell. Contrast-enhanced MRI of Lung cancer, small cell. Contrast-enhanced MRI of the brain in a patient with known small-cell lung cancer (SCLC). Axial section at the level of lateral ventricles shows at least 2 ring-enhancing metastatic lesions in the periventricular region. The brain is one of the predominant sites for SCLC metastasis.
Lung cancer, small cell. Coronal positron emission Lung cancer, small cell. Coronal positron emission tomogram shows abnormal areas of increased metabolic activity in the left hilar and left adrenal regions consistent with a hilar tumor with left adrenal metastasis.
Lung cancer, small cell. Frontal chest radiograph Lung cancer, small cell. Frontal chest radiograph shows extensive disease. A large mass is noted in the left mid lung with an opacity extending to the upper lung. Also present is a right lower lung nodule that suggests a metastatic deposit. Increased right paratracheal opacity indicates lymphadenopathy. A small left pleural effusion is present, with blunting of the costophrenic recess.

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