Small cell carcinoma of the lung surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2] Dildar Hussain, MBBS [3]

The feasibility of surgery depends on the stage of small cell lung carcinoma at diagnosis. In small cell lung carcinoma, surgery should only be considered among patients with clinical stage I (T1-2, N0). Postoperative chemotherapy with or without radiation therapy is recommended based on the presence or absence of lymph node involvement.

• The feasibility of surgery depends on the stage of small cell lung carcinoma at diagnosis.^[1]
• Surgery should only be considered among patients with clinical stage I (T1-2, N0). Given that the majority of patients are not diagnosed with clinical stage I (T1-2,N0), surgery is rarely performed among SCCL patients.^[1][2]
• Before a patient is considered for surgical resection of the tumor, investigation for occult nodal involvement by either mediastinoscopy or mediastinal node dissection should be performed.
• Post-operative palliative treatment following surgery includes:^[1]
  • Chemotherapy if there is no nodal involvement
  • Chemotherapy PLUS radiation therapy if there is nodal involvement
  • Prophylactic cranial irradiation is recommended among patients who undergo complete resection of the tumor,^[3] as long as their performance status is good and they do not have any neurological cognitive impairment.

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