Surgery after initial chemotherapy for localized small-cell carcinoma of the lung.

• DOI: 10.1200/jco.1987.5.10.1579
• Publication Date: 2017-02-23T13:25:50Z
• Authors: C J Williams; I McMillan; R Lea; G Mead; J Thompson; J Sweetenham; A Herbert; M Jefferys; R Buchanan; J M Whitehouse
• Keywords: Thoracotomy

Despite the high response rates induced by chemotherapy, many patients with limited small-cell lung cancer (SCLC) relapse at site of primary disease. Failure radiotherapy to overcome this has led use surgery as part a combined modality approach. Between December 1981 and 1985, 189 SCLC were assessed for suitability after an initial three cycles chemotherapy (doxorubicin, cyclophosphamide, etoposide). Fifty-seven found have disease, these, 19 ineligible or unfit surgery. Of 38 eligible patients, 84% had objective 25 deemed suitable restaging. At thoracotomy, four inoperable, nine lobectomy, 12 pneumonectomy. There was no evidence viable in resection specimens (one stage 1, two 2, one 3 presentation), but entirely separate focus poorly differentiated squamous carcinoma (SqLC) one, remaining contained SCLC. Survival selected undergo tumor excellent (median survival, 33 months; plateau phase, 48% alive 5 years), survival entire group not dissimilar from that reported previous series limited-stage treated alone. Long-term appeared be largely restricted those (no SCLC, zero five relapsed; 13 16 relapsed and/or died). This prospective study confirms feasibility approach, suggests any improvement overall is likely small. Until results multicenter randomized trials are available, surgery, program, should regarded experimental.