The role of pulmonary resection in early stage small cell lung cancer

Abstract

Introduction and objective For many decades, small-Cell Lung Cancer (SCLC) has been considered a non-surgical disease and is traditionally managed by chemo- and radiotherapy. However, recent advances in early detection of pulmonary lesions have made it possible to detect small cell lung cancer at a very early stage of development. The aim of this review was to assess the current state of knowledge on the role of surgical pulmonary resection in patients with early stage SCLC, and to determine the optimal diagnostic and therapeutic strategy for patients with pulmonary nodules suspected for SCLC. Review methods A literature search of the PubMed database was conducted using the key words: ‘small cell lung cancer pulmonary resection not[non]’ in the last 5 years. 99 manuscripts were found. Of these, only dealing directly with surgical pulmonary resection in SCLC were selected. Based on these criteria, 14 publications were identified and included in the review. Brief description of the state of knowledge Current scientific and clinical data reveal that surgical resection offers patients with SCLC considerable therapeutic benefits with favourably high overall survival rates. Analyzed reports showed that the local relapse rate in patients after surgical resection was significantly lower than in the non-surgical group. Furthermore, definitive surgical resection with adjuvant chemotherapy resulted in improved survival for patients with early stage SCLC, when compared to conservative approach. Summary Pulmonary resection of an early stage SCLC as a component of combined treatment offers considerable therapeutic benefits, among which almost 100% local control is of the greatest importance. Up-to-date clinical strategies strongly support the recommendation that peripheral pulmonary lesions suspected to be malign, should be surgically resected, unless serious contraindications are indicated.

Keywords

• surgery
• cancer
• lung
• small-cel