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SMALL CELL LUNG CARCINOMA IN SOUTH TUNISIA: ISSUES
AND DELAY IN ITS MANAGEMENT

M. FRIHA, R. KHEMAKHEM, S. BEN SASSI, M. WALHA, N. KALLEL, N. MOUSSA, I. Yangui,
S. Kammoun

DEPARTMENT OF PULMONOLOGY, HEDI CHAKER HOSPITAL, SFAX- TUNISIA

INTRODUCTION : Small cell lung cancer (SCLC) is a poorly differentiated
neuroendocrine malignancy characterized by aggressive growth and early
metastases. The aim of this study is to evaluate our management of patients with
SCLC.

METHODS : Retrospective comparative study including 453 patients followed for lung
cancer from 2015 to 2022. These patients were divided into 2 groups: group 1 (G1)
including 63 patients followed for SCLC, group 2 (G2) including 390 patients followed
for non-small cell carcinoma.

RESULTS : The mean age in G1-Patients was 63 ± 9years (G2: 61 ± 10 years). A low
socioeconomic level was noted in 90,5% in G1 and 90% in G2 (p= 0.907). Patients in G1
had more dyspnea (62.7% vs 44%, p= 0.01), and Superior vena cava syndrome (21.6%
vs 5.3%, p= 0.00). The initial Performance Status was more impaired in patients with
SCLC (G1: 33.3%, G2:19.9%, p= 0.03). There was not a significant difference in the time
to consultation from the onset of symptoms (p= 0.41). However, the delay between
the consultation and the histological diagnosis was shorter in G1 (22±13 days vs 32±37
days, p= 0.00). All patients in G1 had received chemotherapy (G2: 92.1%, p= 0.02) with
a shorter time to onset compared to diagnostic confirmation (G1: 25 ± 17 days, G2: 34
± 29 days, p= 0.01). The response to first- and second-line chemotherapy and their
complications were the same in both groups. For G1, a higher hospitalization rate
(44.4% vs 26.5%, p= 0.00) and a higher death rate was found (G1: 85.7%, G2: 72%, p= 0.03).
CONCLUSION : SCLC is a therapeutic emergency due to its chemosensitivity and
rapid progression. Despite the shorter time to histological confirmation and
chemotherapy initiation, the prognosis remains poor.

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