Overall Survival and Disease-Free Survival in Small Cell versus Non-Small Cell Lung Cancer Treated with Surgery, Chemotherapy, and Radiotherapy: A Single-Centre Experience from a Peripheral Medical College

Background Lung cancer remains a leading cause of cancer-related mortality worldwide, with non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) demonstrating distinct biological behavior, treatment strategies, and survival outcomes. Comparative data on overall survival (OS) and disease-free survival (DFS) from randomized studies in peripheral medical college settings remain limited. This study aimed to compare OS and DFS between NSCLC and SCLC patients treated with surgery, chemotherapy, radiotherapy, or multimodality approaches.

Methods This prospective, open-label randomized controlled trial included 60 patients with histologically confirmed NSCLC (stages I–III) or limited-stage SCLC treated at a peripheral medical college. Patients were randomized in a 1:1 ratio to receive either surgery-based multimodality treatment or definitive concurrent chemoradiotherapy. Patients were followed regularly for disease recurrence and survival. OS and DFS were analyzed using the Kaplan–Meier method and compared using the log-rank test.

Results With a median follow-up of 24 months, NSCLC patients demonstrated significantly superior survival outcomes compared to SCLC patients. Median OS was 24 months in NSCLC versus 14 months in SCLC (p = 0.01), while median DFS was 18 months and 10 months, respectively (p = 0.02). Surgery-based multimodality treatment resulted in improved OS and DFS, particularly in NSCLC patients. SCLC patients showed higher rates of distant metastasis and overall recurrence despite aggressive treatment.

Conclusion The study confirms the prognostic superiority of NSCLC over SCLC and highlights the benefit of surgery-based multimodality treatment in improving survival outcomes. Early detection, appropriate patient selection for surgery, and strengthening multidisciplinary care are crucial for improving outcomes in peripheral healthcare settings