Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Surgical Outcomes in Small Cell Lung Cancer

  • Ju, Min-Ho (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Hyeong-Ryul (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Joon-Bum (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Yong-Hee (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Dong-Kwan (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Seung-Il (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2011.07.04
  • Accepted : 2011.11.11
  • Published : 2012.02.05
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Abstract

Background: The experience of a single-institution regarding surgery for small cell lung cancer (SCLC) was reviewed to evaluate the surgical outcomes and prognoses. Materials and Methods: From July 1990 to December 2009, thirty-four patients (28 male) underwent major pulmonary resection and lymph node dissection for SCLC. Lobectomy was performed in 24 patients, pneumonectomy in eight, bilobectomy in one, and segmentectomy in one. Surgical complications, mortality, the disease-free survival (DFS) rate, and the overall survival rate were analyzed retrospectively. Results: The median follow-up period was 26 months (range, 4 to 241 months), and there was one surgical mortality (2.9%). Six patients (17.6%) experienced recurrence, all of which were systemic. Eight patients died during follow-up; four died of disease progression and the other four died of pneumonia or of another non-cancerous cause. The three-year DFS rate was $79.2{\pm}2.6%$ and the overall survival rate was $66.4{\pm}10.5%$. Recurrence or death was significantly prevalent in the patients with lymph node metastasis (p=0.001) as well as in those who did not undergo adjuvant chemotherapy (p=0.008). The three-year survival rate was significantly greater in the patients with pathologic stage I/II cancer than in those with stage III cancer (84% vs. 13%, p=0.001). Conclusion: Major pulmonary resection for small cell lung cancer is feasible in selected patients. Patients with pathologic stage I or II disease showed an excellent survival rate after surgery and adjuvant treatment. Prospective randomized studies will be needed to define the role of surgery in early-stage small cell lung cancer.

Keywords

References

  1. Chung KY, Hong GP, Kim KD, Kim DJ, Kim JH. Surgical resection of small cell lung cancer (SCLC). Korean J Thorac Cardiovasc Surg 1998;31:1195-9.
  2. Ichinose Y, Hara N, Ohta M, Takamori S, Kawasaki M, Hata K. Comparison between resected and irradiated small cell lung cancer in patients in stages I through IIIa. Ann Thorac Surg 1992;53:95-100.
  3. Jackman DM, Johnson BE. Small-cell lung cancer. Lancet 2005;366:1385-96.
  4. Kohman LJ. Is there a place for surgery in central small cell lung cancer? Chest Surg Clin N Am 1997;7:105-12.
  5. Meyer JA, Comis RL, Ginsberg SJ, et al. Phase II trial of extended indications for resection is small cell carcinoma of the lung. J Thorac Cardiovasc Surg 1982;83:12-9.
  6. Warde P, Payne D. Does thoracic irradiation improve survival and local control in limited-stage small-cell carcinoma of the lung? A meta-analysis. J Clin Oncol 1992;10:890-5.
  7. Shields TW, Higgins GA Jr, Matthews MJ, Keehn RJ. Surgical resection in the management of small cell carcinoma of the lung. J Thorac Cardiovasc Surg 1982;84:481-8.
  8. Inoue M, Miyoshi S, Yasumitsu T, et al. Surgical results for small cell lung cancer based on the new TNM staging system. Thoracic Surgery Study Group of Osaka University, Osaka, Japan. Ann Thorac Surg 2000;70:1615-9.
  9. Shepherd FA, Ginsberg RJ, Patterson GA, Evans WK, Feld R. A prospective study of adjuvant surgical resection after chemotherapy for limited small cell lung cancer: a University of Toronto Lung Oncology Group study. J Thorac Cardiovasc Surg 1989;97:177-86.
  10. Mountain CF. Clinical biology of small cell carcinoma: relationship to surgical therapy. Semin Oncol 1978;5:272-9.
  11. Shepherd FA, Ginsberg RJ, Feld R, Evans WK, Johansen E. Surgical treatment for limited small-cell lung cancer. The University of Toronto Lung Oncology Group experience. J Thorac Cardiovasc Surg 1991;101:385-93.
  12. Elliott JA, Osterlind K, Hirsch FR, Hansen HH. Metastatic patterns in small-cell lung cancer: correlation of autopsy findings with clinical parameters in 537 patients. J Clin Oncol 1987;5:246-54.
  13. Shah SS, Thompson J, Goldstraw P. Results of operation without adjuvant therapy in the treatment of small cell lung cancer. Ann Thorac Surg 1992;54:498-501.
  14. Schreiber D, Rineer J, Weedon J, et al. Survival outcomes with the use of surgery in limited-stage small cell lung cancer: should its role be re-evaluated? Cancer 2010;116:1350-7.
  15. Coolen L, Van den Eeckhout A, Deneffe G, Demedts M, Vansteenkiste J. Surgical treatment of small cell lung cancer. Eur J Cardiothorac Surg 1995;9:59-64.
  16. Meyer JA, Comis RL, Ginsberg SJ, et al. The prospect of disease control by surgery combined with chemotherapy in stage I and stage II small cell carcinoma of the lung. Ann Thorac Surg 1983;36:37-41.
  17. Ulsperger E, Karrer K, Denck H. Multimodality treatment for small cell bronchial carcinoma. Preliminary results of a prospective, multicenter trial. The ISC-Lung Cancer Study Group. Eur J Cardiothorac Surg 1991;5:306-9.
  18. Turrisi AT 3rd, Kim K, Blum R, et al. Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide. N Engl J Med 1999;340:265-71.
  19. Eberhardt W, Korfee S. New approaches for small-cell lung cancer: local treatments. Cancer Control 2003;10:289-96.
  20. Asamura H, Kameya T, Matsuno Y, et al. Neuroendocrine neoplasms of the lung: a prognostic spectrum. J Clin Oncol 2006;24:70-6.

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