Outcome of surgery for small cell lung cancer response to induction chemotherapy predicts survival

Background: The role of surgery for local control of small cell lung cancer (SCLC) is controversial. Methods: Sixty-nine consecutive patients who underwent complete resection of SCLC in our hospital were reviewed. The patients included 62 men and 7 women. Clinical stage at the time of diagnosis was c-stages IA and B in 29, c-stages IIA and B in 12, c-stage IIIA in 21, and c-stage IIIB in 7. Results: Thirty-two patients received induction chemotherapy, and 37 patients underwent initial surgery. The overall response rate to induction chemotherapy was 71.9%. The survival rate stratified by clinical stage at the time of diagnosis was 48.9% for c-stage I, 33.3 % for c-stage II, 20.2 % for c-stage IIIA, and 0% for c-stage IIIB. Downstaging after induction chemotherapy conferred a survival benefit. Survival after lobectomy or bilobectomy was better than after pneumonectomy. Patients who received adjuvant chemotherapy survived longer than patients who did not. Conclusions: Surgery combined with chemotherapy is a therapeutic option in selected patients with SCLC. Pathologic nodal status and response to induction chemotherapy are predictors of survival.