Surgical treatment of peripheral small cell lung cancer

Approximately 5% of small cell lung cancer (SCLC) patients present with an asymptomatic peripheral tumor (solitary pulmonary nodule) on "routine" chest radiography. In this setting, the diagnosis of SCLC is often made at thoracotomy. Complete resection, mediastinal lymph node sampling, and postoperative chemotherapy are indicated. If the diagnosis is made preoperatively, multiorgan scanning and mediastinoscopy are required prior to thoracotomy. Survival for pathologic stage I SCLC treated by surgery and postoperative chemotherapy is comparable to survival for surgically treated stage I non-SCLC.