The Journal of Thoracic and Cardiovascular Surgery, Vol 77, 243-248, Copyright © 1979 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Selective surgical resection in small cell carcinoma of the lung
JA Meyer, RL Comis, SJ Ginsberg, PM Ikins, WA Burke and FB Parker Jr
Surgical resection has failed notably as definitive treatment for small
cell carcinoma of the lung. Newer treatment programs combining intensive
chemotherapy with radiation therapy achieve a significant response in about
85 percent of cases, with about 50 percent of patients showing clinically
complete remission. Long-term survival without recurrence has been the
outcome in a small minority of cases. A frequent mode of failure after
treatment of limited disease is recurrence within the chest. The course of
one patient treated early in this series suggests that exclusion of initial
surgical resection from programs of combined treatment may be a serious
omission. Since that time, four patients have undergone initial resection,
apparently with uniformly favorable courses to date. Selection criteria
based on staging factors are proposed. Admittedly, only a minority of
patients will be suitable for this treatment at the time of first
diagnosis. Much opportunity exists for improvement in survival rates of
patients, even those with limited disease.