Surgical resection could improve the survival of patients with early-stage small cell lung cancer (SCLC). However, there is a lack of dedicated studies concentrating on surgical treatment in older patients with T1-2N0M0 SCLC. Thus, we performed this population-based study to investigate whether older patients with T1-2N0M0 SCLC could benefit from surgery.

We collected the data of patients with SCLC between 2000 and 2015 from the Surveillance, Epidemiology, and End Results Program database. Older patients (≥ 65 years) with T1-2N0M0 SCLC were included, and we converted the staging information into those of the eighth edition. The propensity score matching (PSM) was used to balance the distribution of clinical characteristics between surgery and no-surgery groups.

Before PSM, the distribution proportions of clinical characteristics in 1,229 patients were unbalanced. The Kaplan–Meier curves of overall survival (OS) and cancer-specific survival (CSS) showed that the patients in the surgery group were better than those in the non-surgery group (all P < 0.001). After 1:2 PSM, the distribution proportions of clinical characteristics in 683 patients were balanced (all P > 0.05). The OS and CSS of patients in the surgery group were still better than that of patients in the no-surgery group (all P < 0.001), and subgroup analysis showed that the surgery was a protective factor for OS and CSS in all clinical characteristics subgroups (almost P < 0.001). The multivariate Cox analysis further confirmed this result (OS: HR, 0.33; 95% CI, 0.27–0.39; P < 0.001; CSS: HR, 0.29; 95% CI, 0.23–0.36; P < 0.001). The result of subgroup analysis based on age, T stage, and adjuvant therapy showed that surgery was related to better OS and CSS compared with non-surgery group (almost P < 0.001) and that lobectomy exhibited the longer survival than sublobectomy. Age, sex, and race were the independent prognostic factors for OS in patients undergoing surgery, whereas only the factor of age affects the CSS in patients with surgery.

Older patients with T1-2N0M0 SCLC can benefit significantly from surgical treatment, and lobectomy provides better prognosis than sublobectomy.

手术切除可以提高早期小细胞肺癌（SCLC）患者的生存率。然而，缺乏专注于老年 T1-2N0M0 SCLC 患者手术治疗的专门研究。因此，我们进行了这项基于人群的研究，以调查 T1-2N0M0 的老年 SCLC 患者是否可以从手术中受益。

我们从监测、流行病学和最终结果计划数据库中收集了 2000 年至 2015 年期间 SCLC 患者的数据。纳入 T1-2N0M0 SCLC 的老年患者（≥ 65 岁），我们将分期信息转换为第八版的分期信息。倾向评分匹配（PSM）用于平衡手术组和非手术组之间临床特征的分布。

在 PSM 之前，1,229 名患者的临床特征分布比例不平衡。总生存期 (OS) 和癌症特异性生存期 (CSS) 的 Kaplan-Meier 曲线显示，手术组患者优于非手术组患者（均磷< 0.001)。1:2 PSM后，683例患者临床特征分布比例均衡（均磷> 0.05)。手术组患者的 OS 和 CSS 仍优于非手术组患者（均磷< 0.001），亚组分析显示手术是所有临床特征亚组（几乎磷< 0.001)。多变量 Cox 分析进一步证实了这一结果（OS：HR，0.33；95% CI，0.27-0.39；磷< 0.001; CSS：人力资源，0.29；95% CI，0.23–0.36；磷< 0.001)。基于年龄、T 分期和辅助治疗的亚组分析结果表明，与非手术组相比，手术与更好的 OS 和 CSS 相关（几乎磷< 0.001)，并且肺叶切除术比亚肺叶切除术的生存期更长。年龄、性别和种族是手术患者 OS 的独立预后因素，而只有年龄因素影响手术患者的 CSS。

T1-2N0M0 SCLC 的老年患者可从手术治疗中显着受益，并且肺叶切除术比亚肺叶切除术提供更好的预后。