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Updated: Nov 2, 2025

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].

C Al Zreibi1, L Gibault2, E Fabre3

  • 1Hôpital Européen Georges-Pompidou, service de chirurgie thoracique, 20, rue Leblanc, Paris 75908, France.

Revue Des Maladies Respiratoires
|June 8, 2021
PubMed
Summary
This summary is machine-generated.

Surgery offers survival benefits for early-stage small-cell lung cancer (SCLC). Multimodal treatment, including lobectomy and chemotherapy, is crucial for localized SCLC, but advanced stages require careful multidisciplinary evaluation.

Keywords:
Adjuvant therapyCancer à petites cellulesChirurgieSmall-cell lung cancerSurgeryTraitement adjuvant

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Area of Science:

  • Oncology
  • Thoracic Surgery
  • Medical Oncology

Background:

  • Small-cell lung cancer (SCLC) is an aggressive neuroendocrine carcinoma, frequently diagnosed at a metastatic stage.
  • Surgical eligibility is limited to a small subset of patients with localized disease, often based on outdated evidence.
  • Current treatment guidelines for SCLC surgery are primarily derived from older clinical trials and registry data.

Purpose of the Study:

  • To evaluate the role and outcomes of surgical intervention in the multimodal management of small-cell lung cancer.
  • To assess patient selection criteria and treatment sequences for operable SCLC.
  • To determine the survival impact of surgery in early-stage SCLC.

Main Methods:

  • Review of existing phase II/III trials and registry studies.
  • Analysis of surgical procedures, including lobectomy and lymph node dissection.
  • Evaluation of adjuvant and neoadjuvant chemotherapy regimens in conjunction with surgery.
  • Assessment of patient selection factors such as age, performance status, and comorbidities.

Main Results:

  • Surgery, typically lobectomy with lymph node removal, is feasible for select early-stage SCLC (pT1-2N0M0) within a multimodal approach.
  • Adjuvant platinum-etoposide chemotherapy is recommended for resected stage I SCLC.
  • Survival rates for early-stage SCLC treated with surgery and adjuvant chemotherapy range from 30% to 58% at 5 years.
  • The role of surgery in locally advanced SCLC (T3-T4 or N2) is limited, though some registry data suggest potential survival benefits in N2 disease.

Conclusions:

  • Surgery plays a vital role in achieving complete resection for early-stage SCLC, significantly improving survival.
  • Treatment sequencing (neoadjuvant vs. adjuvant) remains a point of controversy due to clinical practice heterogeneity.
  • Multidisciplinary evaluation is essential for optimizing treatment strategies in rare and heterogeneous SCLC cases.