Clinical features and outcome of small cell lung cancer in female patients: a large-cohort retrospective study

Abstract Background: Currently, female small cell lung cancer (SCLC) incidence has been increasing. However, there have been few large database-based studies on female patients with SCLC. In this study, we used Surveillance, Epidemiology, and End Results (SEER) database to describe the clinical characteristics and prognosis of female SCLC patients.Methods: SCLC patients from the SEER database between 1973 and 2015 were included. Gender, age, race, stage, tumor size, and metastasis status were included in our study. Clinical characteristics were analyzed among females and males with SCLC. Survival analyses were conducted with log-rank tests and Cox proportional hazard models.Results: A total of 18234 patients were extracted from SEER database. 50.2% of the whole SCLC patients were females. Compared with males, females were less likely to be Asians, carry bigger size of tumor, have later TNM stage, and have distant metastases (P < 0.05). Gender proved to be an independent prognostic factor for SCLC patients (CSS:HR:1.105;95% CI: 1.068 1.143; P < 0.001; OS: HR, 1.120;95% CI: 1.084 1.158; P < 0.001). Female patients presented more favorable survival than male patients (Median OS/CSS:11 vs. 9 months, P < 0.001). Our results confirmed that age≥65, white race, later stage, tumor size ≥ 50mm and distant metastases were all associated with poor prognosis in female patients.Conclusions: Female gender is associated with more favorable outcome of SCLC. For females, patients who are senile, white people, and have poorer pathological features were associated with a shorter OS, which need to be more circumspectly treated in clinical practice.