Neuroendocrine tumors of the lung: the role of surgery in small cell lung cancer.

The role of surgery in the management of patients with SCLC remains controversial. Although 2 randomized studies have failed to show any benefit on survival by adding surgery to chemotherapy, retrospective and prospective reports showed that surgery offers a reasonable overall survival in a subset of patients with stage I and II SCLC. Patients' selection is fundamental, and it should include extensive radiologic staging and mediastinal lymph-node biopsy. The use of a PET scan is likely to improve the accuracy of staging. Through primary surgery or after induction chemotherapy, a complete tumor resection associated with systematic lymphadenectomy should be achieved.