MS11.05 Pathological Reporting of Resected Lung Cancer — the Importance of Using Additional TNM Descriptors

Abstract

more SCLC patients may become long-term survivors. Austin et al. carried out a multinational study of baseline and annual repeat CT screenings of 48,037 volunteers at risk for lung cancer. (9) They found 48 SCLC cases, 92% of which were asymptomatic at diagnosis. Clinical stage was IA in 16 patients (33%), II in 5 (11%), III in 20 (42%), and IV in 7 (15%). Estimated cure rates were 36% overall and 54% for the clinical stage I cases. Conclusions: Surgical resection is indicated in SCLC in stages I and IIA after precise staging including mediastinoscopy. Patients should receive systemic therapy after resection and mediastinal radiation therapy in cases with nodal metastases. Surgical resection in stages I and IIA SCLC is concordant with NCCN and ASCO guidelines; however, surgery is offered only in one-third of the patients in the absence of any documented contraindication. CT screening identifies SCLC at an earlier stage and offers the hope that more SCLC patients may be candidates for surgical resection and become longterm survivors. Selected cases in stages IIB and IIIA may be candidates for surgery as part of the multidisciplinary treatment. References: 1) Fox W, Scadding JG. Medical Research Council comparative trial of surgery and radiotherapy for primary treatment of small-celled or oatcelled carcinoma of bronchus. Ten-year follow-up. Lancet. 1973; 2: 63e5.) 2) Pignon JP, Arriagada R, Ihde DC, et al. A meta-analysis of thoracic radiotherapy for small-cell lung cancer. N Engl J Med. 1999;341:476-484. Warde P, Payne D. Does thoracic irradiation improve survival and local control in limited-stage small-cell carcinoma of the lung? A meta-analysis.