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Role of pulmonary resection in the diagnosis and treatment of limited-stage small cell lung cancer: revision of clinical diagnosis based on findings of resected specimen and its influence on survival.
MedLine Citation:
PMID:  22237738     Owner:  NLM     Status:  In-Data-Review    
PURPOSE: Our aims were to evaluate (1) the result of surgical treatment of limited-stage small cell lung cancer (SCLC) by examining long-term survival and prognostic factors, (2) the diagnostic role of surgery by comparing clinical and histopathological diagnoses and staging, and (3) the impact of preoperative diagnostic accuracy on survival.
METHODS: We retrospectively reviewed the clinical profiles of 37 patients treated at our institution between January 1990 and December 2007 for SCLC diagnosed using surgical specimens.
RESULTS: The median follow-up period was 41.2 months, and the 5-year survival rate was 57.5%. Lobectomy or wider resection was performed alone in 33 cases and with mediastinal dissection in 29 cases. Fifteen patients did not receive chemotherapy. SCLC was diagnosed preoperatively or intraoperatively in 75% and non-SCLC in 25%. Clinical stage 1 disease was diagnosed in 29 patients; however, pathological stage 1 was seen in only 20. Patients at pathological stage 1 disease showed better survival than those at stage 2, but a similar result was not obtained in the case of clinical stage of the disease. Tumor size and nodal stage were the only significant factors influencing survival in a multivariate analysis. The adequacy of preoperative clinical diagnosis of tumor extensiveness, nodal involvement, and clinical stage did not significantly influence survival.
CONCLUSION: Surgery for limited-stage SCLC was associated with a favorable survival rate and provided important pathological information that can help predict survival. Accuracy of preoperative diagnoses showed no apparent impact on survival for surgically treated SCLC patients.
Takashi Iwata; Noritoshi Nishiyama; Koshi Nagano; Nobuhiro Izumi; Shinjiro Mizuguchi; Takuma Tsukioka; Ryuhei Morita; Kyukwang Chung; Shoji Hanada; Kiyotoshi Inoue
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Publication Detail:
Type:  Journal Article     Date:  2012-01-13
Journal Detail:
Title:  General thoracic and cardiovascular surgery     Volume:  60     ISSN:  1863-6713     ISO Abbreviation:  Gen Thorac Cardiovasc Surg     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101303952     Medline TA:  Gen Thorac Cardiovasc Surg     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  43-52     Citation Subset:  IM    
Department of Thoracic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan,
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