title: Current role of surgery in small cell lung carcinoma.
abstract: Small cell lung carcinoma represents 15-20% of lung cancer. Is is characterized by rapid growth and early disseminated disease with poor outcome. For many years surgery was considered a contraindication in Small Cell Lung Cancer (SCLC) since radiotherapy and chemoradiotherapy were found to be more efficient in the management of these patients. Never the less some surgeons continue to be in favor of surgery as part of a combined modality treatment in patients with SCLC. The reevaluation of the role of surgery in this group of patients is based on clinical data indicating a much better prognosis in selected patients with limited disease (T1-2, N0, M0), the high rate of local recurrence after chemoradiotherapy with surgery considered eventually more efficient in the local control of the disease and the fact that surgery is the most accurate tool to access the response to chemotherapy, identify carcinoids misdiagnosed as SCLC and treat the Non Small Cell Lung Cancer component of mixed tumors. Performing surgery for local disease SCLC requires a complete preoperative assessment to exclude the presence of nodal involvement. In stage I surgery must always be followed by adjuvant chemotherapy, while in stage II and III surgery must be planned only in the context of clinical trials and after a pathologic response to induction chemoradiotherapy has been confirmed. Prophylactic cranial irradiation should be used to reduce the incidence of brain metastasis.
authors: Department of Cardiothoracic Surgery, School of Medicine, University of Patras, Greece. ekoletsis@hotmail.com
authors: Efstratios N
authors: EN
authors: Koletsis
authors: Christos
authors: C
authors: Prokakis
authors: Menelaos
authors: M
authors: Karanikolas
authors: Efstratios
authors: E
authors: Apostolakis
authors: Dimitrios
authors: D
authors: Dougenis
mesh_terms: D003131:Combined Modality Therapy; D019317:Evidence-Based Medicine; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D009367:Neoplasm Staging; D018579:Patient Selection; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D016896:Treatment Outcome