Surgery for small cell lung cancer

Operative management of small cell lung cancer generally yields little benefit because these tumors are known for their propensity to disseminate early to regional lymph nodes and distant sites. Primary surgery followed by chemotherapy is however indicated in very early stage tumors where survival approximates that of resected non small cell lung tumors. Surgery as an adjuvant to combination chemotherapy is also advocated by some authors to downstage the tumor and render it resectable. Candidates for salvage procedures include patients who have achieved complete response with chemotherapy, but subsequently relapsed within the chest at the site of the primary tumor.