Long term survival after pulmonary resection for small cell carcinoma of the lung.

A retrospective review was undertaken of the long term survival of 97 patients with histologically proved small cell carcinoma of the lung resected during the 10 years January 1977-December 1986. Twenty seven patients (28%) had stage I disease, 29 (30%) stage II, and 41 (42%) stage III. Patients with stage I and II tumours were managed by resection alone. Patients with stage III disease received adjuvant chemotherapy (cyclophosphamide, doxorubicin, and vincristine). Pneumonectomy was undertaken in 75 patients, lobectomy in 21, and wedge resection in one patient. Three patients died within 30 days of operation. The cumulative five year survival of all patients, irrespective of tumour stage, was 17%. The cumulative five year survival was 35% for patients with stage I disease, 23% for stage II, and zero for stage III. The median survival for patients with stage III tumours was 17 months. There was no significant difference in cumulative survival between patients with stage I and II disease. Cumulative survival, however, was significantly better for patients with stage I and II disease than for those with stage III disease. The data suggest that for patients with stage I and stage II disease surgery offers the prospect of long term survival.