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Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer

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Surgery for small cell lung cancer: When and how.

Monica Casiraghi¹, Giulia Sedda¹, Ester Del Signore²

¹Division of Thoracic Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy.

Lung Cancer (Amsterdam, Netherlands)

|December 28, 2020

Summary

Surgery may benefit select small cell lung cancer (SCLC) patients. Stage I SCLC patients who undergo surgical resection show significantly longer survival, suggesting they are ideal candidates for this approach.

Keywords:

Small-cell lung cancer Surgery Survival

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Published on: September 8, 2023

Area of Science:

Oncology
Thoracic Surgery
Cancer Research

Background:

The role of surgery in treating small cell lung cancer (SCLC) is under review due to emerging data from large observational studies.
Retrospective data suggest potential survival benefits for SCLC patients undergoing surgical intervention.

Purpose of the Study:

To evaluate the outcomes and survival results of patients diagnosed with SCLC who underwent surgery with curative intent.
To identify patient subgroups within SCLC that may benefit most from surgical treatment.

Main Methods:

Retrospective analysis of 324 SCLC patients treated between 1998 and 2018.
Comparison of overall survival (OS) using Kaplan-Meier and Cox regression analyses for patients who underwent surgical resection.
Evaluation of patient stages and adjuvant treatment modalities, including chemotherapy (CT) and radiotherapy (RT).

Main Results:

Of 65 patients undergoing surgical resection, 39 had upfront surgery, and 24 had surgery after chemotherapy (CT) or CT plus radiotherapy (RT).
Patients with clinical stage I SCLC who underwent surgical resection demonstrated significantly longer survival, with a 5-year OS of 62.9% (p < 0.0001).
Overall median survival at 1, 5, and 10 years was 81.4%, 41.4%, and 25.4%, respectively.

Conclusions:

Stage I SCLC patients are the best candidates for surgical resection within a multidisciplinary treatment setting.
For patients with stage II and III SCLC, careful selection for surgery is crucial due to poorer survival outcomes; alternative therapies should be considered.