Hidefumi Takei1, Haruhiko Kondo, Etsuo Miyaoka, Hisao Asamura, Ichiro Yoshino, Hiroshi Date, Meinoshin Okumura, Hirohito Tada, Yoshitaka Fujii, Yoichi Nakanishi, Kenji Eguchi, Hirotoshi Dosaka-Akita, Hideo Kobayashi, Noriyoshi Sawabata, Kohei Yokoi. 1. *Department of General Thoracic Surgery, Kyorin University, Tokyo; †Department of Mathematics, Science University of Tokyo; ‡Division of Thoracic Surgery, National Cancer Center Hospital, Tokyo; §Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba; ‖Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, Kyoto, ¶Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, #Division of General Thoracic Surgery, Osaka City General Hospital, Osaka; **Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Science and Medical School, Nagoya; ††Department of Clinical Medicine, Research Institute for Diseases of the Chest, Faculty of Medical Sciences, Kyushu University, Fukuoka; ‡‡Department of Medical Oncology, Teikyo University School of Medicine, Tokyo; §§Department of Medical Oncology, Hokkaido University Graduate School of Medicine, Sapporo; ‖‖Division of Respiratory Disease, National Defense Medical College, Tokorozawa; and ¶¶Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Abstract
INTRODUCTION: Indications for surgical resection for small cell lung cancer (SCLC) have been very limited. Because early-stage SCLC is a rare presentation of lung cancer, studies comparing surgical resection among a large number of patients are unlikely to be conducted. This study reports the most recent surgical outcomes of a large number of SCLC patients who underwent surgery in 2004. METHODS: In 2010, the Japanese Joint Committee of Lung Cancer Registry performed a nationwide retrospective registry study regarding the prognosis and clinicopathologic profiles of 11,663 patients who underwent resection for primary lung cancer in 2004. Of the 11,663 patients, 243 patients with SCLC (2.1%) were included in this study. The registry data of the patients with SCLC were analyzed, and the clinicopathologic profiles and surgical outcomes of the patients were evaluated. RESULTS: The 5-year survival rate for all cases (n = 243, 213 males, mean age 68.2 years) was 52.6%. The 5-year survival rates by c-stage and p-stage were as follows: IA, 64.3% (n = 132) and 72.3% (n = 93); IB, 45.7% (n = 36) and 61.1% (n = 51); IIA, 50.5% (n =25); and 44.8% (n = 27); IIB, 33.3% (n = 10) and 40.3% (n = 17); IIIA, 30.5% (n = 30) and 23.4% (n = 45); and IV, 0% (n = 7) and 0% (n = 9), respectively. A multivariate analysis showed that the significant prognostic factors were age, gender, c-stage, and surgical curability. A kappa value was moderate conformity between c-stage and p-stage in all cases. CONCLUSIONS: Surgical resection in selected patients with early-stage SCLC, especially stage I, had favorable results.
INTRODUCTION: Indications for surgical resection for small cell lung cancer (SCLC) have been very limited. Because early-stage SCLC is a rare presentation of lung cancer, studies comparing surgical resection among a large number of patients are unlikely to be conducted. This study reports the most recent surgical outcomes of a large number of SCLCpatients who underwent surgery in 2004. METHODS: In 2010, the Japanese Joint Committee of Lung Cancer Registry performed a nationwide retrospective registry study regarding the prognosis and clinicopathologic profiles of 11,663 patients who underwent resection for primary lung cancer in 2004. Of the 11,663 patients, 243 patients with SCLC (2.1%) were included in this study. The registry data of the patients with SCLC were analyzed, and the clinicopathologic profiles and surgical outcomes of the patients were evaluated. RESULTS: The 5-year survival rate for all cases (n = 243, 213 males, mean age 68.2 years) was 52.6%. The 5-year survival rates by c-stage and p-stage were as follows: IA, 64.3% (n = 132) and 72.3% (n = 93); IB, 45.7% (n = 36) and 61.1% (n = 51); IIA, 50.5% (n =25); and 44.8% (n = 27); IIB, 33.3% (n = 10) and 40.3% (n = 17); IIIA, 30.5% (n = 30) and 23.4% (n = 45); and IV, 0% (n = 7) and 0% (n = 9), respectively. A multivariate analysis showed that the significant prognostic factors were age, gender, c-stage, and surgical curability. A kappa value was moderate conformity between c-stage and p-stage in all cases. CONCLUSIONS: Surgical resection in selected patients with early-stage SCLC, especially stage I, had favorable results.