SURGICAL RESECTION FOR SMALL-CELL CARCINOMA OF THE LUNG - A RETROSPECTIVE STUDY

Background - A retrospective review was undertaken of the survival of 21 patients with histologically proven small cell carcinoma of the lun g resected between 1977 and 1991. Methods - Twenty one patients (20 me n) of median age 60 (range 44-73) years underwent surgical resection. Patients were subjected to standard clinical staging procedures. Preop erative diagnosis was small cell carcinoma of the lung in 13, non-smal l cell lung cancer in one, and uncertain in seven patients. Clinical s taging was stage I disease in 11 and stage II in 10 patients. Results - Resection included pneumonectomy in 12 cases, lobectomy in eight, an d one wedge resection. Resection was complete in 16 patients. Postoper ative histopathological examination confirmed small cell carcinoma of the lung in 19 specimens and mixed small cell and nonsmall cell carcin oma of the lung in two. Pathological staging was stage I in 11, stage II in three, and stage III in seven patients. The final pathological d iagnosis of the resected specimens (n=18) was atypical carcinoid in on e, pure small cell carcinoma of the lung in 15, and mixed small cell a nd non-small cell carcinoma of the lung in two patients. Fourteen pati ents also received chemotherapy and 10 received prophylactic cranial i rradiation postoperatively. Excluding the patient with a final diagnos is of atypical carcinoid, the median survival (n=20) was 29 months (ra nge two to 133+). Median survival for patients with pathological stage I and II disease (n=13) was 40 months (range nine to 133+) and for pa tients with pathological stage III disease (n=7) 20 months (range two to 116+). The median disease free survival was 23 months. Eleven patie nts relapsed between two and 101 months. There was no advantage for th ose patients who received postoperative chemotherapy. Conclusion - Cur ative resection offers the best chance for long term survival in patie nts with small cell carcinoma of the lung with very limited stage dise ase.