Outcome of surgery for small cell lung cancer -- response to induction chemotherapy predicts survival

Thorac Cardiovasc Surg. 2004 Aug;52(4):206-10. doi: 10.1055/s-2004-821075.


Background: The role of surgery for local control of small cell lung cancer (SCLC) is controversial.

Methods: Sixty-nine consecutive patients who underwent complete resection of SCLC in our hospital were reviewed. The patients included 62 men and 7 women. Clinical stage at the time of diagnosis was c-stages IA and B in 29, c-stages IIA and B in 12, c-stage IIIA in 21, and c-stage IIIB in 7.

Results: Thirty-two patients received induction chemotherapy, and 37 patients underwent initial surgery. The overall response rate to induction chemotherapy was 71.9 %. The survival rate stratified by clinical stage at the time of diagnosis was 48.9 % for c-stage I, 33.3 % for c-stage II, 20.2 % for c-stage IIIA, and 0 % for c-stage IIIB. Downstaging after induction chemotherapy conferred a survival benefit. Survival after lobectomy or bilobectomy was better than after pneumonectomy. Patients who received adjuvant chemotherapy survived longer than patients who did not.

Conclusions: Surgery combined with chemotherapy is a therapeutic option in selected patients with SCLC. Pathologic nodal status and response to induction chemotherapy are predictors of survival.

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Carcinoma, Small Cell / drug therapy*
  • Carcinoma, Small Cell / pathology
  • Carcinoma, Small Cell / surgery
  • Female
  • Humans
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoadjuvant Therapy / methods*
  • Neoplasm Staging
  • Pneumonectomy / methods
  • Prognosis
  • Remission Induction / methods
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome