title: Surgical outcomes in small cell lung cancer.
abstract: BACKGROUND
  The experience of a single-institution regarding surgery for small cell lung cancer (SCLC) was reviewed to evaluate the surgical outcomes and prognoses.
  
  
  METHODS
  From July 1990 to December 2009, thirty-four patients (28 male) underwent major pulmonary resection and lymph node dissection for SCLC. Lobectomy was performed in 24 patients, pneumonectomy in eight, bilobectomy in one, and segmentectomy in one. Surgical complications, mortality, the disease-free survival (DFS) rate, and the overall survival rate were analyzed retrospectively.
  
  
  RESULTS
  The median follow-up period was 26 months (range, 4 to 241 months), and there was one surgical mortality (2.9%). Six patients (17.6%) experienced recurrence, all of which were systemic. Eight patients died during follow-up; four died of disease progression and the other four died of pneumonia or of another non-cancerous cause. The three-year DFS rate was 79.2±2.6% and the overall survival rate was 66.4±10.5%. Recurrence or death was significantly prevalent in the patients with lymph node metastasis (p=0.001) as well as in those who did not undergo adjuvant chemotherapy (p=0.008). The three-year survival rate was significantly greater in the patients with pathologic stage I/II cancer than in those with stage III cancer (84% vs. 13%, p=0.001).
  
  
  CONCLUSIONS
  Major pulmonary resection for small cell lung cancer is feasible in selected patients. Patients with pathologic stage I or II disease showed an excellent survival rate after surgery and adjuvant treatment. Prospective randomized studies will be needed to define the role of surgery in early-stage small cell lung cancer.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Korea.
authors.forename: Min Ho
authors.initials: MH
authors.lastname: Ju
authors.forename: Hyeong Ryul
authors.initials: HR
authors.lastname: Kim
authors.forename: Joon-Bum
authors.initials: JB
authors.lastname: Kim
authors.forename: Yong Hee
authors.initials: YH
authors.lastname: Kim
authors.forename: Dong Kwan
authors.initials: DK
authors.lastname: Kim
authors.forename: Seung-Il
authors.initials: SI
authors.lastname: Park