[Surgical treatment for small cell lung cancer]

Results of surgical treatment for small cell lung cancer were reviewed to confirm the role of surgery. Most of the surgical therapy was performed with post or pre-operative chemotherapy. Clinical staging of small cell lung cancer treated by chemotherapy and/or radiotherapy has not been classified according to the TNM staging system, which made it difficult to compare the results of surgical treatment with non-surgical treatment in detail. Results of surgical treatment for small cell lung cancer according to the TNM staging system reported in 1990's were as follows. For stage I diseases, nearly all the patients underwent complete resection followed by standard chemotherapy. Five-year survival rates were over 50% in most of the reports. Surgical resection followed by chemotherapy is the standard therapy for stage I diseases. For stage II diseases, the greater part of patients were treated by complete resection followed by chemotherapy, which resulted in five-year survival rates of 28-35%. Nationwide statistics on surgical resection for small cell lung cancer in Japan revealed that the stage I and II diseases are actually resected, and the five-year survival rate reached 37%. Thus, surgery followed by chemotherapy for stage II diseases is becoming the standard therapy. For stage IIIA diseases, surgical resection after chemotherapy followed by chemotherapy and/or radiotherapy has been tried investigationally. The five-year survival rates of 16-48% in these patients suggests the increasing role of surgery for these patients.