[Combined surgical treatment for limited small cell lung cancer: clinical analysis of 51 cases].
OBJECTIVE
Small cell lung cancer (SCLC) is usually widely disseminated at the time of diagnosis due to its rapid growth. Therefore chemotherapy is the predominant form of treatment for SCLC. However, chemotherapy normally ended in failure as a consequence of recurrence of primary tumor or mediastinal lymphatic nodes. The objective of this study was to investigate whether combined surgical treatment for SCLC can control primary tumor more effectively and increase the survival of the patients.


METHODS
Fifty-one cases of limited SCLC treated with surgery from May 1981 to May 2001 in Cancer Center, Sun Yat-sen University were reviewed retrospectively.


RESULTS
According to 1997 international staging system, there were 7 patients with stage IB(13.7%), 5 with stage IIA(9.8%), 15 with stage IIB (29.4%), 20 with stage IIIA (39.2%) and 4 with stage IIIB (7.8%). Twelve patients received pneumonectomy, 35 lobectomy, 3 segmentectomy, and 1 exploration. Thirteen patients were treated with surgery alone and 38 of them combined with 2-6 cycles of pre- or post- operative chemotherapy. The median survival time was 20.8 months. The overall 1-, 3-, and 5-year survival rates were 43.0%, 25.9%, and 20.1%, respectively. The 1-, 3-, and 5-year survival rates for patients with stage IB were 100.0%, 80.0%, and 30.0% respectively, with stage II were 79.7%, 39.8%, and 34.5%, respectively, with stage III were 52.4%, 21.8%, and 5.46%, respectively. The 1-,3-, and 5-year survival rates for patients treated by surgery combined with chemotherapy were 77.5%, 38.5%, and 23.8% and that of surgery alone were 41.7%, 16.7%, and 8.3%, respectively (P< 0.01).


CONCLUSIONS
Combined surgical treatment can increase the survival rate of SCLC more effectively and should be considered as an important modality in multi-disciplinary treatment of limited small cell lung cancer.
Su
Xiao-Dong
XD
Department of Thoracic Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, PR China. dxdsu@hotmail.com
Huang
Zhi-Fan
ZF
Rong
Tie-Hua
TH
Yang
Ming-Tian
MT
D000328:Adult; D000368:Aged; D018288:Carcinoma, Small Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate