Treatment modality selection and prognosis of early stage small cell lung cancer: retrospective analysis from a single cancer institute.

We evaluated the role of surgery followed by either chemotherapy (ChT) alone or chemotherapy and thoracic radiotherapy (ChT/TRT) versus sequential ChT/TRT in patients with clinical stage I or stage II small cell lung cancer (SCLC). Ninety-six patients received surgery (complete resection) followed by either ChT alone or ChT/TRT (Group I), while 49 patients were treated exclusively with sequential ChT/TRT (Group II). The ChT regimens consisted of either carboplatin/etoposide or cisplatin/etoposide. The total TRT dose was 50-60 Gy. For the whole group (n = 145), the median survival time was 54 months, and the 5-year overall survival (OS) rate was 48%. The corresponding figures for Group I were 91 months and 57%, respectively, and for Group II, they were 34.6 months and 31.4% respectively (P = 0.004). Multivariate analysis revealed that a Karnofsky Performance Status score ≥ 80 [hazard ratio (HR), 0.281; P = 0.015] and the treatment modality including surgery (HR, 0.503; P = 0.004) were independent favourable prognostic factors for OS.