Surgery in small cell lung cancer.
Surgery in small cell lung cancer (SCLC) was abandoned in the late 1960s but is currently being cautiously reassessed, after the Armed Forces Asymptomatic Pulmonary Nodule Study demonstrated an unexpectedly prolonged 5-year survival (36%) with surgery. Subsequent prospective studies have reported five-year survival following resection in 22 to 83% of patients with Stage I disease and in 0 to 50% of patients with Stages II and III disease. Ten percent of patients with SCLC may be amenable to this approach. Additional patients may become candidates for resection following intensive combination chemotherapy. The optimal postoperative management remains unsettled. Combination chemotherapy and prophylactic cranial irradiation is recommended following complete resection. Postoperative thoracic irradiation may benefit patients with pathologically involved mediastinal nodes. Correlation of clinical response with our new understanding of the molecular biology of SCLC may further improve our approach to this disease.
Graham
B L
BL
Division of Medical Oncology and Thoracic Surgery, University of Mississippi Medical Center, Jackson.
Balducci
L
L
Khansur
T
T
Dalton
M L
ML
Lambuth
B
B
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018288:Carcinoma, Small Cell / Q000601:surgery* / Q000628:therapy; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery* / Q000628:therapy; D011446:Prospective Studies; D012189:Retrospective Studies