Surgery for small cell lung cancer

Small-cell lung cancer (SCLC) accounts for approximately 20% of lung cancers. Its biological features and response to therapy distinguish it from non-small-cell lung cancer (NSCLC)1. SCLC is rapidly proliferating, has early systemic dissemination, and is responsive to chemotherapy. Several decades ago, surgery was the treatment of choice for both SCLC and NSCLC. Poor results of SCLC were reported by many surgeons2'3 and were emphasized by the UK Medical Research Council randomized trial comparing surgery with radiotherapy4'5. Although survival was dismal in both treatment arms, radiotherapy was superior to surgery, and it became the treatment of choice for SCLC. In the 1970s, combination chemotherapy was shown to be effective in SCLC6'7. Chemotherapy quickly became, and remains today, the essential treatment modality for SCLC8'9. However, there has been some resurgence in interest in surgery for SCLC1O12. In this article, we critically review the place of surgery in the treatment of SCLC, and attempt to provide a balanced perspective on this controversial area of lung cancer treatment. BACKGROUND SCLC is usually disseminated at the time of initial diagnosis. About two-thirds of patients have 'extensive' disease and one-third have 'limited' disease. These staging terms were introduced when radiotherapy was the mainstay of SCLC treatment, and they are still used8'9. Limited disease is

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Surgery for small cell lung cancer

Cited by 3 publications

References 20 publications