{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T04:55:28Z","timestamp":1781585728559,"version":"3.54.5"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003787","name":"Natural Science Foundation of Hebei Province","doi-asserted-by":"publisher","award":["H2025206698"],"award-info":[{"award-number":["H2025206698"]}],"id":[{"id":"10.13039\/501100003787","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007452","name":"Wu Jieping Medical Foundation","doi-asserted-by":"publisher","award":["320.6750.2021\u201001\u201010"],"award-info":[{"award-number":["320.6750.2021\u201001\u201010"]}],"id":[{"id":"10.13039\/100007452","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Given the limited evidence on prognostic factors specifically for older patients with extensive\u2010stage small cell lung cancer (ES\u2010SCLC), a population with distinct clinical characteristics, this study aimed to validate whether previously reported prognostic indicators retain their predictive value in this vulnerable group. A retrospective analysis was conducted on data from 270 older ES\u2010SCLC patients who received treatment at the Fourth Hospital of Hebei Medical University between December 2016 and June 2024. By the final follow\u2010up date of October 15, 2024, 212 deaths had been recorded. The median progression\u2010free survival (mPFS) was 6.7\u2009months (95% confidence interval [CI] 6.0\u20137.4), and the median overall survival (mOS) was 13.1\u2009months (95% CI 11.8\u201314.4). For PFS, univariate and multivariate Cox analyses identified first\u2010line chemotherapy (CT) and old\u2010old (\u2265\u200975\u2009years) as independent adverse prognostic factors. For OS, old\u2010old, a positive smoking history, bone metastasis, and high\u2010lactate dehydrogenase (&gt;\u2009250\u2009U\/L) were identified as significant adverse prognostic factors. Notably, high\u2010pro\u2010gastrin\u2010releasing peptide (ProGRP) (&gt;\u200969.2\u2009pg\/mL) was significantly associated with an increased risk of death during the follow\u2010up period beyond 10\u2009months (HR\u2009=\u20091.85, 95% CI 1.05\u20133.26,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.032); conversely, no significant association was observed within the initial 10\u2009months of follow\u2010up (HR\u2009=\u20090.84, 95% CI 0.44\u20131.60,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.604). In conclusion, these findings not only corroborate the prognostic value of previously identified risk factors in older patients with ES\u2010SCLC but also demonstrate that the prognostic impact of ProGRP is distinctly time\u2010dependent.\n                  <\/jats:p>","DOI":"10.1002\/cam4.71885","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T16:05:48Z","timestamp":1777305948000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Identification of Prognostic Risk Factors in Older Patients With Extensive\u2010Stage Small Cell Lung Cancer"],"prefix":"10.1002","volume":"15","author":[{"given":"Jiayin","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Medical Oncology The Fourth Hospital of Hebei Medical University  Shijiazhuang Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology The Fourth Hospital of Hebei Medical University  Shijiazhuang Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology The Fourth Hospital of Hebei Medical University  Shijiazhuang Hebei China"},{"name":"Cangzhou Central Hospital  Cangzhou Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology The Fourth Hospital of Hebei Medical University  Shijiazhuang Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology The Fourth Hospital of Hebei Medical University  Shijiazhuang Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology The Fourth Hospital of Hebei Medical University  Shijiazhuang Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhisong","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology The Fourth Hospital of Hebei Medical University  Shijiazhuang Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology The Fourth Hospital of Hebei Medical University  Shijiazhuang Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology The Fourth Hospital of Hebei Medical University  Shijiazhuang Hebei 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University  Shijiazhuang Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zuo","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology The Fourth Hospital of Hebei Medical University  Shijiazhuang Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8302-5518","authenticated-orcid":false,"given":"Yudong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology The Fourth Hospital of Hebei Medical University  Shijiazhuang Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jncc.2024.01.006"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.0560"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-023-00798-3"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.35281"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40164-024-00548-w"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40425-019-0690-1"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2022.264"},{"key":"e_1_2_13_10_1","unstructured":"National Comprehensive Cancer Network \u201cNCCN Clinical Practice Guidelines in Oncology: Older Adult Oncology \u201dNCCN Clinical Practice Guidelines in Oncology. National Comprehensive Cancer Network. Available from https:\/\/www.nccn.org\/guidelines."},{"key":"e_1_2_13_11_1","unstructured":"National Bureau of Statistics \u201cAnnual data on China's population age structure and dependency ratio for the year 2024 \u201dNational Data\u2014National Bureau of Statistics of China. Available from https:\/\/data.stats.gov.cn\/."},{"key":"e_1_2_13_12_1","first-page":"169","article-title":"Incidence and Mortality of Cancer in Elderly Population in China","volume":"23","author":"Meng F.","year":"2023","journal-title":"Journal of Evidence\u2043Based Medicine"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/crj.12632"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.08.010"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.02588"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2008.10.026"},{"key":"e_1_2_13_17_1","article-title":"Prognostic Significance of Neutrophil\u2010To\u2010Lymphocyte Ratio in Small Cell Lung Cancer in the Era of Immunotherapy","volume":"43","author":"Kumar N. 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