REVIEW PAPER
 
KEYWORDS
TOPICS
ABSTRACT
Introduction and objective:
For many decades, small-Cell Lung Cancer (SCLC) has been considered a non-surgical disease and is traditionally managed by chemo- and radiotherapy. However, recent advances in early detection of pulmonary lesions have made it possible to detect small cell lung cancer at a very early stage of development. The aim of this review was to assess the current state of knowledge on the role of surgical pulmonary resection in patients with early stage SCLC, and to determine the optimal diagnostic and therapeutic strategy for patients with pulmonary nodules suspected for SCLC.

Review methods:
A literature search of the PubMed database was conducted using the key words: ‘small cell lung cancer pulmonary resection not[non]’ in the last 5 years. 99 manuscripts were found. Of these, only dealing directly with surgical pulmonary resection in SCLC were selected. Based on these criteria, 14 publications were identified and included in the review.

Brief description of the state of knowledge:
Current scientific and clinical data reveal that surgical resection offers patients with SCLC considerable therapeutic benefits with favourably high overall survival rates. Analyzed reports showed that the local relapse rate in patients after surgical resection was significantly lower than in the non-surgical group. Furthermore, definitive surgical resection with adjuvant chemotherapy resulted in improved survival for patients with early stage SCLC, when compared to conservative approach.

Summary:
Pulmonary resection of an early stage SCLC as a component of combined treatment offers considerable therapeutic benefits, among which almost 100% local control is of the greatest importance. Up-to-date clinical strategies strongly support the recommendation that peripheral pulmonary lesions suspected to be malign, should be surgically resected, unless serious contraindications are indicated.

Sagan D, Galek T, Prystupa T. The role of pulmonary resection in early stage small cell lung cancer. J Pre-Clin Clin Res. 2021; 15(4): 199–203. doi: 10.26444/jpccr/145094
 
REFERENCES (29)
1.
Barnes H, See K, Barnett S, Manser R. Surgery for limited-stage small-cell lung cancer. Cochrane Database Syst Rev. 2017 Apr 21;4(4):CD011917.doi: 10.1002/14651858.CD011917.pub2.
 
2.
Wang Y, Zou S, Zhao Z, Liu P, Ke C, Xu S. New insights into small-cell lung cancer development and therapy. Cell Biol Int. 2020 Aug;44(8):1564–1576. doi: 10.1002/cbin.11359. Epub 2020 Apr 18.
 
3.
Xu L, Zhang G, Song S, Zheng Z. Surgery for small cell lung cancer: A Surveillance, Epidemiology, and End Results (SEER) Survey from 2010 to 2015. Medicine (Baltimore). 2019 Oct;98(40):e17214. doi: 10.1097/ MD.0000000000017214.
 
4.
Zhao H, Ren D, Liu H, Chen J. Comparison and discussion of the treatment guidelines for small cell lung cancer. Thorac Cancer. 2018 Jul;9(7):769–774. doi: 10.1111/1759–7714.12765. Epub 2018 May 16.
 
5.
Low M, Ben-Or S. Thoracic Surgery in Early-Stage Small Cell Lung Cancer. Thorac Surg Clin. 2018 Feb;28(1):9–14. doi: 10.1016/j. thorsurg.2017.08.003. Epub 2017 Oct 18.
 
6.
van Meerbeeck JP, Fennell DA, De Ruysscher DK. Small-cell lung cancer. Lancet. 2011 Nov 12;378(9804):1741–55. doi: 10.1016/S0140–6736(11)60165–7. Epub 2011 May 10.
 
7.
Veronesi G, Bottoni E, Finocchiaro G, Alloisio M. When is surgery indicated for small-cell lung cancer? Lung Cancer. 2015 Dec;90(3):582–9. doi: 10.1016/j.lungcan.2015.10.019. Epub 2015 Oct 17.
 
8.
Zhong L, Suo J, Wang Y, Han J, Zhou H, Wei H, Zhu J. Prognosis of limited-stage small cell lung cancer with comprehensive treatment including radical resection. World J Surg Oncol. 2020 Feb 3;18(1):27. doi:10.1186/s12957–020–1807–1. PMID: 32013993; PMCID: PMC6998207.
 
9.
Lou Y, Zhong R, Xu J, Qiao R, Teng J, Zhang Y, Zhang X, Chu T, Zhong H, Han B. Does surgically resected small-cell lung cancer without lymph node involvement benefit from prophylactic cranial irradiation? Thorac Cancer. 2020 May;11(5):1239–1244. doi: 10.1111/1759–7714.13381. Epub 2020 Mar 6. PMID: 32142599; PMCID: PMC7180625.
 
10.
Paximadis P, Beebe-Dimmer JL, George J, Schwartz AG, Wozniak A, Gadgeel S. Comparing Treatment Strategies for Stage I Small-cell lung Cancer. Clin Lung Cancer. 2018 Sep;19(5):e559-e565. doi: 10.1016/j.cllc.2018.03.017. Epub 2018 Mar 23. PMID: 29656869; PMCID:PMC6152878.
 
11.
Engelhardt KE, Coughlin JM, DeCamp MM, Denlinger CE, Meyerson SL, Bharat A, Odell DD. Survival after adjuvant radiation therapy in localized small cell lung cancer treated with complete resection. J.Thorac Cardiovasc Surg. 2019 Dec;158(6):1665–1677.e2. doi: 10.1016/j. jtcvs.2019.08.031. Epub 2019 Sep 9. PMID: 31627955; PMCID: PMC7405041.
 
12.
Stinchcombe TE. Current Treatments for Surgically Resectable, Limited-Stage, and Extensive-Stage Small Cell Lung Cancer. Oncologist. 2017 Dec;22(12):1510–1517. doi: 10.1634/theoncologist.2017–0204. Epub 2017 Aug 4. PMID: 28778960; PMCID: PMC5728020.
 
13.
Wei S, Wei B, Tian J, Song X, Wu B, Hu P. Propensity Score Matching Analysis for the Role of Surgery in Small Cell Lung Cancer. Oncol Res Treat. 2020;43(6):276–288. doi: 10.1159/000506867. Epub 2020 May 11. PMID: 32392569.
 
14.
Rucker AJ, Raman V, Jawitz OK, Voigt SL, Tong BC, D’Amico TA, Harpole DH. Effect of Lymph Node Assessment on Outcomes in Surgery for Limited Stage Small Cell Lung Cancer. Ann Thorac Surg. 2020 Dec;110(6):1854–1860. doi: 10.1016/j.athoracsur.2020.04.117. Epub 2020 Jun 13. PMID: 32544452; PMCID: PMC7958968.
 
15.
Yao Y, Zhou Y, Yang Z, Huang H, Shen H. Adjuvant Chemotherapy Following Surgical Resection Improves Survival in Patients With Early Stage Small Cell Lung Cancer. Oncol Res. 2019 Feb 5;27(2):203–210. doi: 10.3727/096504018X15202953107093. Epub 2018 Mar 9. PMID: 29523217; PMCID: PMC7848360.
 
16.
Liu Y, Shan L, Shen J, Liu L, Wang J, He J, He Q, Jiang L, Guo M, Chen X, Zeng H, Xia X, Peng G, Liang W, He J. Choice of surgical procedure – lobectomy, segmentectomy, or wedge resection – for patients with stage T1–2N0M0 small cell lung cancer: A population-based study. Thorac Cancer. 2019 Apr;10(4):593–600. doi: 10.1111/1759–7714.12943. Epub 2019 Mar 10. PMID: 30854808; PMCID: PMC6449329.
 
17.
Wang Y, Pang Z, Chen X, Yan T, Liu J, Du J. Development and validation of a prognostic model of resectable small-cell lung cancer: a large population-based cohort study and external validation. J Transl Med. 2020 Jun 15;18(1):237. doi: 10.1186/s12967–020–02412-x. PMID: 32539859; PMCID: PMC7296644.
 
18.
Zhao X, Kallakury B, Chahine JJ, Hartmann D, Zhang Y, Chen Y, Zhang H, Zhang B, Wang C, Giaccone G. Surgical Resection of SCLC: Prognostic Factors and the Tumor Microenvironment. J Thorac Oncol. 2019 May;14(5):914–923. doi: 10.1016/j.jtho.2019.01.019. Epub 2019 Feb 5. PMID: 30735815; PMCID: PMC6510981.
 
19.
Guo Y, Yang L, Liu L, Wei J, Teng F, Zhang J, Zhu Y, Xing P, Li J. Comparative study of clinicopathological characteristics and prognosis between combined and pure small cell lung cancer (SCLC) after surgical resection. Thorac Cancer. 2020 Oct;11(10):2782–2792. doi: 10.1111/1759–7714.13591. Epub 2020 Aug 11. PMID: 32779385; PMCID: PMC7529571.
 
20.
Pan Y, Kong FW, Wang H, Wang X, Zhang H, Wu WB, Zhang M. A recurrence-free survivor with chemotherapy-refractory small cell lung cancer after pneumonectomy: A case report and review of the literature. Medicine (Baltimore). 2017 Nov;96(47):e8922. doi: 10.1097/ MD.0000000000008922. PMID: 29382030; PMCID: PMC5709029.
 
21.
Zeng Q, Li J, Tan F, Sun N, Mao Y, Gao Y, Xue Q, Gao S, Zhao J, He J. Development and Validation of a Nomogram Prognostic Model for Resected Limited-Stage Small Cell Lung Cancer Patients. Ann Surg Oncol. 2021 Sep;28(9):4893–4904. doi: 10.1245/s10434–020–09552-w. Epub 2021 Mar 2. PMID: 33655361; PMCID: PMC8349336.
 
22.
Eberhardt W, Stamatis G, Stuschke M et al. Prognostically oriented multimodality treatment including surgery for selected patients of small-cell lung cancer patients stages IB to IIIB: long term results of a phaseII trial. Brit J Cancer 1999;81(7):1206–12.
 
23.
National Lung Screening Trial Research Team. Lung Cancer Incidence and Mortality with Extended Follow-up in the National Lung Screening Trial. J Thorac Oncol. 2019 Oct;14(10):1732–1742. doi: 10.1016/j. jtho.2019.05.044. Epub 2019 Jun 28.
 
24.
Li J, Zhao Y, Li C, Zhu L, Liu C, Liu L. The revision of 8th edition TNM stage criteria is more accurate in prediction postoperative survival for SCLC patients. Int J Surg. 2017 Dec;48:83–85. doi: 10.1016/j. ijsu.2017.09.072. Epub 2017 Oct 5.
 
25.
Casiraghi M, Sedda G, Del Signore E, Piperno G, Maisonneuve P, Petrella F, de Marinis F, Spaggiari L. Surgery for small cell lung cancer: When and how. Lung Cancer. 2021 Feb;152:71–77. doi: 10.1016/j. lungcan.2020.12.006. Epub 2020 Dec 22.
 
26.
D’Amico TA. Commentary: Surgery for small cell lung cancer: This is the way. J Thorac Cardiovasc Surg. 2021 Mar;161(3):772–773. doi:10.1016/j. jtcvs.2020.11.090. Epub 2020 Nov.
 
27.
de Hoyos A, DeCamp MM. Surgery for small cell lung cancer. Thorac Surg Clin. 2014 Nov;24(4):399–409. doi: 10.1016/j.thorsurg.2014.07.005.Epub 2014 Sep 6.
 
28.
Chenesseau J, Bourlard D, Cluzel A, Trousse D, D’Journo XB, Thomas PA. Intent-to-cure surgery for small-cell lung cancer in the era of contemporary screening and staging methods. Interact Cardiovasc Thorac Surg. 2020 Apr 1;30(4):541–545. doi: 10.1093/icvts/ivz299.
 
29.
Schneider BJ, Saxena A, Downey RJ. Surgery for early-stage small cell lung cancer. J Natl Compr Canc Netw. 2011 Oct;9(10):1132–9. doi: 10.6004/jnccn.2011.0094.
 
eISSN:1898-7516
ISSN:1898-2395
Journals System - logo
Scroll to top