Abstract:Objective: To evaluate the incidence of malignant pericardial effusion (MPCE) and its prognostic risk factors at presentation in patients with small-cell lung cancer (SCLC) . Methods: This study retrospectively analyzed the clinical data of SCLC patients from the SEER (Surveillance, Epidemiology, and End Results) database between 2004 and 2015. The Kaplan-Meier method and log-rank test were used to estimate the overall survival (OS) and the Cox proportional hazard model was used to assess whether MPCE was an independent risk factor for prognosis. Then we used univariate and multivariate analyses to explore the independent prognostic factors of SCLC with MPCE. Results: Among the 74 125 patients with SCLC, MPCE was present in 1 694 (2.29%) cases. The probability of MPCE was higher in female patients with larger tumors and higher lymph node stages at presentation. Compared with patients without MPCE, the OS in patients with MPCE was significantly worse (median survival time: 3 months vs.7 months; estimated 1-year OS: 16.50% vs. 29.53%; 2-year OS: 7.67% vs.13.19%; P<0.001) . Multivariate analysis showed MPCE was also an independent factor for poor prognosis of SCLC (HR=1.41, 95% CI=1.34-1.48; P<0.001) . In 1 694 cases of SCLC with MPCE, multivariate analysis showed that age, gender, N stage, radiotherapy and chemotherapy were independent prognostic factors. Conclusion: SCLC patients with MPCE are rare (2.29%) with poor OS, and the patients with younger age at diagnosis, female and lower N stage have a better prognosis. Radiotherapy and chemotherapy can significantly improve the prognosis of the patients.
