The objective of this retrospective study was to investigate prognostic factors associated with survival ofpatients with extensive stage small cell lung cancer (ES-SCLC). Included were 200 patients admitted to theLiberation Army General Hospital with a diagnosis of ES-SCLC. The demographics of patients, diseasecharacteristics, pre-treatment biochemical parameters and therapeutic plan were assessed or evaluated.Univariate analysis found that second-line chemotherapy, radiotherapy, and no liver metastasis were associatedwith improved survival. Tumor response to first-line chemotherapy and normal initial hemoglobin levels werealso associated with a survival benefit (all P-values ≤ 0.0369). Multivariate Cox regression analysis indicatedthat liver metastasis and the total number of all chemotherapy cycles were independent prognostic factors ofsurvival. The morbidity risk in patients with liver metastasis was 2.52-fold higher than that in patients withoutliver metastasis (hazard ratio (HR)=2.52 (1.69-3.76); P<0.0001). However, one unit increase in the total numberof chemotherapy cycles decreased the risk of death by 0.86-fold (HR=0.86 (0.80-0.92); P<0.0001). Absence ofliver metastasis and ability of a patient to receive and tolerate multiple lines of chemotherapy were associatedwith longer survival.