Surgical results of resectable small cell lung cancer.
BACKGROUND
The standard of care for patients with small cell lung cancer (SCLC) is chemotherapy and radiotherapy, even for patients with limited disease. To define the role of surgical resection in patients with limited SCLC, we investigated the outcomes of patients diagnosed with limited-stage disease (LD) SCLC.


METHODS
The records of 57 LD SCLC patients who underwent surgical resection from April 1974 to March 2012 were retrospectively analyzed.


RESULTS
There were six women and 51 men, with a median age of 63.5 years. The overall five-year survival rate was 28.6% (median, 18.2 months). The p-stage II and III patients had a significantly worse survival than the p-stage I patients (13.4% vs. 43.4%, P = 0.0036). However, the c-stage was not found to correlate with survival. Patients who underwent pneumonectomy had a significantly worse outcome than those who underwent other surgical procedures (0.0% vs. 32.0%, P = 0.0002). In a multivariate Cox proportional hazards analysis, p-stage II or III (hazard ratio [HR] 3.040 P = 0.0017) and pneumonectomy (HR 6.177, P = 0.00159) were significant independent predictors of an adverse survival outcome.


CONCLUSIONS
Surgical treatment can be considered in SCLC patients with pathologically proven N0 status, although pneumonectomy should be avoided.
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University Fukuoka, Japan.
Daigo
D
Kawano
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University Fukuoka, Japan.
Tatsuro
T
Okamoto
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University Fukuoka, Japan.
Takatoshi
T
Fujishita
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University Fukuoka, Japan.
Yuzo
Y
Suzuki
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University Fukuoka, Japan.
Hirokazu
H
Kitahara
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University Fukuoka, Japan.
Shinichiro
S
Shimamatsu
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University Fukuoka, Japan.
Yoshihiko
Y
Maehara
Limited-stage disease; pneumonectomy; small cell lung cancer