Operation for N2 small cell lung carcinoma

• Published in: The Annals of thoracic surgery Vol. 49; no. 5; pp. 759 - 762
• Main Authors: Salzer, Georg M., Müller, Ludwig C., Huber, Heinz, Denz, Hubert, Gasser, Rudolf, Frommhold, Hermann, Ebner, Ingrid
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-05-1990; Elsevier Science
• Subjects: Adult; Aged; Biological and medical sciences; Carcinoma, Small Cell - mortality; Carcinoma, Small Cell - pathology; Carcinoma, Small Cell - secondary; Carcinoma, Small Cell - surgery; Combined Modality Therapy; Female; Humans; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Lung Neoplasms - surgery; Lymphatic Metastasis; Male; Medical sciences; Middle Aged; Neoplasm Staging; Pneumology; Recurrence; Survival Rate; Tumors of the respiratory system and mediastinum; Human; Respiratory disease; Staging; Indication; Metastasis; Malignant tumor; Radiotherapy; Bronchopulmonary; Five year survival; Result; Chemotherapy; Treatment; Exeresis; Surgery; Tumor; Oat cell carcinoma
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/0003-4975(90)90016-Y

Of 48 patients with limited small cell lung carcinoma treated by different modes, but always including radical operation, a series of 25 patients with N2 lymph node metastases is reported. In a first period (1970 to 1977) treatment consisted solely of radical resection in 3 patients; chemotherapy was added to operation in 6, and local radiotherapy was added in 2. Since 1977, 14 patients were treated according to a comprehensive therapy protocol including radical resection (six pneumonectomies, one bilobectomy, seven lobectomies), chemotherapy, local radiotherapy, and prophylactic cranial irradiation. Eleven patients, in whom N2 disease was confirmed preoperatively, received chemotherapy as the first step, followed by “adjuvant” resection. Projected 5-year survival rate is 25% for the entire N2 group and 47% for the comprehensively treated group. Seven patients of this latter group are alive 12, 19, 30, 48, 66, 73, and 74 months after comprehensive therapy, equivalent to an observed 2-year survival rate of 38%. This is the largest reported series of patients with resected small cell lung carcinoma in the N2 stage treated at a single institution; the results are so encouraging that we can no longer advocate general refusal of radical lung resection for small cell lung carcinoma in the N2 stage if it is part of a multimodal therapentic protocol.