Several studies have demonstrated the effectiveness of amrubicin (AMR) in small-cell lung cancer (SCLC). This study aimed to assess the change in the prognosis of SCLC before and after the commercial availability of AMR. We retrospectively analyzed data from 243 patients with newly diagnosed SCLC. Patients diagnosed before the start of the sale of AMR (January 1997-May 2002) constituted Group A, and patients diagnosed after its introduction (December 2002-December 2006), constituted Group B. The overall survival and demographic factors of the 2 groups were compared. Similar comparisons were also performed on subsets. Median survival time (MST) was 313 days for Group A and 388 days for Group B (P=0.031). Group B with limited disease (LD) demonstrated a significantly longer median survival time (321 vs. 506 days; P=0.022) than Group A, whereas no significant difference was noted between the groups of patients with extensive disease (ED) (296 vs. 280 days; P=0.895). In the subset of refractory relapse of LD, the MST was clearly longer in Group B than in Group A (220 vs. 321 days; P<0.001). Multivariate analysis for LD patients indicated that performance status (hazard ratio 2.072; P=0.003) and commercial availability of AMR (0.596; P=0.022) are significant factors. The present study has demonstrated prolonged survival times for LD patients since the start of the sale of AMR. The use of AMR in ED patients requires further investigations.