Surgical resection should be considered for stage i and II small cell carcinoma of the lung

Benny Weksler, Katie S. Nason, Manisha Shende, Rodney J. Landreneau, Arjun Pennathur

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Small cell lung carcinoma (SCLC) is rarely treated with resection, either alone or combined with other modalities. This study evaluated the role of surgical resection in the treatment of stage I and II SCLC. We queried the Surveillance, Epidemiology, and End Results (SEER) database for patients from 1988 to 2007 with SCLC. Survival was determined by Kaplan-Meier analysis and compared using the log-rank test. A Cox proportional hazard model identified relevant survival variables. We identified 3,566 patients with stage I or II SCLC. Lung resection was performed in 895 (25.1%), wedge resection in 251 (28.0%), lobectomy or pneumonectomy in 637 (71.2%), and lung resection not otherwise specified in 7 (0.78%). Median survival was 34.0 months (95% confidence interval [CI], 29.0 to 39.0 months) vs 16.0 months (95% CI, 15.3 to 16.7; p < 0.001) in nonsurgical patients. Median survival after lobectomy or pneumonectomy was 39.0 months (95% CI, 30.7 to 40.3) and significantly longer than after wedge resection (28.0 months; 95% CI, 23.2 to 32.8; p = 0.001). However, survival after wedge resection was still significantly longer than survival in nonsurgical patients (p < 0.001). Sex (p = 0.013), age, stage at diagnosis, radiotherapy, and operation (all p < 0.001) significantly affected survival. In the surgical patients, sex (p = 0.001), age (p < 0.001), final stage (p < 0.001), and type of resection (p = 0.01) were important determinants of survival. Surgical resection as a component of treatment for stage I or II SCLC is associated with significantly improved survival and should be considered in the management of early-stage SCLC.

Original languageEnglish (US)
Pages (from-to)889-893
Number of pages5
JournalAnnals of Thoracic Surgery
Volume94
Issue number3
DOIs
StatePublished - Sep 1 2012
Externally publishedYes

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Small Cell Lung Carcinoma
Survival
Confidence Intervals
Pneumonectomy
Lung
Kaplan-Meier Estimate
Proportional Hazards Models
Epidemiology
Radiotherapy
Databases
Therapeutics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Surgical resection should be considered for stage i and II small cell carcinoma of the lung. / Weksler, Benny; Nason, Katie S.; Shende, Manisha; Landreneau, Rodney J.; Pennathur, Arjun.

In: Annals of Thoracic Surgery, Vol. 94, No. 3, 01.09.2012, p. 889-893.

Research output: Contribution to journalArticle

Weksler, Benny ; Nason, Katie S. ; Shende, Manisha ; Landreneau, Rodney J. ; Pennathur, Arjun. / Surgical resection should be considered for stage i and II small cell carcinoma of the lung. In: Annals of Thoracic Surgery. 2012 ; Vol. 94, No. 3. pp. 889-893.
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