Results of surgical treatment for patients with small cell lung cancer.

OBJECTIVE

This study investigated the clinical features and the postoperative prognosis in patients with small cell lung cancer (SCLC).

SUBJECTS

In this study, 1373 patients underwent a resection of lung cancer between 1980 and 2006. There were 53 patients (3.8%) with SCLC among them. They were divided into two groups, including the early (1980-1993) and late (1994-2004) period groups. The clinicopathologic features and the results of surgery were investigated.

RESULTS

The early and late period groups consisted of 22 and 31 patients, respectively. The pathologic stage of early group was stage IA in five, IB in three, II in five, IIIA in five, and IIIB in four patients and of late group was stage 0 in two, IA in three, IB in three, II in seven, IIIA in nine, and IIIB in seven patients. The survival rates 5 years after surgery were 8.7 and 38.3%, respectively. Preoperative chemotherapy with CAV (cyclophosphamide, doxorubicin, vincristine) or PE (cis-diamminedichloroplatinum + VP16) regimens was performed in 11 patients in the early period group. The treatment response was evaluated as a partial response in eight patients and stable disease in three. In the late period group, cis-diamminedichloroplatinum/carboplatin + VP16 therapies were administered to eight patients. The treatment response was evaluated as a complete response in two patients and partial response in six.

CONCLUSION

Surgery could be performed with a curative intent in only a small number of patients with limited disease of SCLC or significant nodal response after chemotherapy. The prognosis after surgery was not satisfactory, especially in the early period. It was considered to be partly because of differences in the regimens and dose intensity of chemotherapy between the early and late period.