title: Survival of patients with small cell lung cancer undergoing lung resection in England, 1998-2009.
abstract: BACKGROUND
  Chemotherapy or chemoradiotherapy is the recommended treatment for small cell lung cancer (SCLC), except in stage I disease where clinical guidelines state there may be a role for surgery based on favourable outcomes in case series. Evidence supporting adjuvant chemotherapy in resected SCLC is limited but this is widely offered.
  
  
  METHODS
  Data on 359 873 patients who were diagnosed with a first primary lung cancer in England between 1998 and 2009 were grouped according to histology (SCLC or non-SCLC (NSCLC)) and whether they underwent a surgical resection. We explored their survival using Kaplan-Meier analysis and Cox regression, adjusting for age, sex, comorbidity and socioeconomic status.
  
  
  RESULTS
  The survival of 465 patients with resected SCLC was lower than patients with resected NSCLC (5-year survival 31% and 45%, respectively), but much higher than patients of either group who were not resected (3%). The difference between resected SCLC and NSCLC diminished with time after surgery. Survival was superior for the subgroup of 198 'elective' SCLC cases where the diagnosis was most likely known before resection than for the subgroup of 267 'incidental' cases where the SCLC diagnosis was likely to have been made after resection.
  
  
  CONCLUSIONS
  These data serve as a natural experiment testing the survival after surgical management of SCLC according to NSCLC principles. Patients with SCLC treated surgically for early stage disease may have survival outcomes that approach those of NSCLC, supporting the emerging clinical practice of offering surgical resection to selected patients with SCLC.
authors.affiliation: Cancer Epidemiology and Population Health, King's Health Partners Cancer Centre, , London, UK.
authors.forename: Margreet
authors.initials: M
authors.lastname: Lüchtenborg
authors.forename: Sharma P
authors.initials: SP
authors.lastname: Riaz
authors.forename: Eric
authors.initials: E
authors.lastname: Lim
authors.forename: Richard
authors.initials: R
authors.lastname: Page
authors.forename: David R
authors.initials: DR
authors.lastname: Baldwin
authors.forename: Erik
authors.initials: E
authors.lastname: Jakobsen
authors.forename: Peter
authors.initials: P
authors.lastname: Vedsted
authors.forename: Mike
authors.initials: M
authors.lastname: Lind
authors.forename: Michael D
authors.initials: MD
authors.lastname: Peake
authors.forename: Anders
authors.initials: A
authors.lastname: Mellemgaard
authors.forename: James
authors.initials: J
authors.lastname: Spicer
authors.forename: Loic
authors.initials: L
authors.lastname: Lang-Lazdunski
authors.forename: Henrik
authors.initials: H
authors.lastname: Møller
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D059248:Chemoradiotherapy / Q000379:methods; D015331:Cohort Studies; D004739:England; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018579:Patient Selection; D011013:Pneumonectomy / Q000401:mortality; D055752:Small Cell Lung Carcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D016896:Treatment Outcome
keywords: Lung Cancer; Small Cell Lung Cancer