Results of surgery in small cell carcinoma of the lung

The experiences published by various groups have re-opened the debate on the role of surgery in the management of patients with small cell lung cancer, especially in those with early stage disease (T1-T2 N0). Our study reports the survival rate of 47 patients with small cell lung cancer treated surgically.

Ours is a prospective study that selected patients with lung cancer recommended for surgery (n=2994) between 1993 and 1997 based on operability criteria accepted by the Bronchogenic Carcinoma Cooperative Group of the Spanish Society of Pneumology and Thoracic Surgery. We report the clinical as well as pathological stages of the patients with small cell lung cancer (n=47), later analysing the 5-year survival rate after surgery using the Kaplan-Meier method.

In 31 patients (66%), resection was complete; 3 patients (6%) received induction treatment and 30 (64%) adjuvant treatment. Five years later, 26% (95% CI 12-40%) of the patients that received surgical treatment were still alive. When we analysed the patients that underwent complete resection, 31% (95% CI 13-49%) survived 5 years or more. In patients at stage Ip (n=15), 36% (95% CI 11-61%) were still living after 5 years.

Until future studies compare surgery plus chemotherapy versus chemotherapy and radiotherapy, it seems reasonable to offer surgical treatment to those patients with early stage small cell lung cancer (T1-T2-N0).