Late recurrence of small-cell lung cancer: treatment and outcome

The 2-year survival of patients with small-cell lung cancer (SCLC) with limited disease is about 25% and the survival curve continues to decline after 2 years. We reviewed 34 cases of survivors of SCLC who had been free of disease for 2 years and who constituted 12.2% of the 278 patients with SCLC newly diagnosed at our institution from 1977 to 1991. The cancer had recurred in 13 patients, 10 of whom were treated with chemotherapy and/or radiotherapy, and 1 complete and 1 partial response were obtained. Three patients received only supportive care because of poor performance status. The median survival after recurrence in the 13 patients was 7.4 months (range 0-39 months). A second primary cancer was noted in 5 patients, but 3 of them died from recurrence of SCLC. The prognosis of patients with late recurrence of SCLC was relatively good, and it seems that adequate treatment in such cases may lead to long-term survival.