Summary
Poor long-term results following the surgical management of small cell carcinoma have
contributed to the opinion that small cell carcinoma is a non-surgical disease; polychemotherapy
is generally given preference. As nowadays adequate therapy (chemotherapy) achieves
control of local tumor growth as well as of extended metastases, surgical resections
should be discussed from a different viewpoint: “Does surgery profit from modern chemotherapy?
” In our clinic, 1332 patients have been operated on for bronchogenic carcinoma from
1973 to 1983: 170 (12.8 %) suffered from small cell carcinoma. The indications for
surgery were either non-histologically classified tumors (e.g. peripheral coin lesions)
or small cell carcinomas stage I, and only in rare cases for palliative reasons. Lobectomy,
including bronchoplastic and arterioplastic resections (n = 108), was the most common
procedure. The postoperative mortality was 15 %, the average survival 341 days, the
latter having improved significantly since 1979 when a postoperative polychemotherapy
(ACO) was instigated. Recent results of surgical resection after primary chemotherapy
are encouraging. Nevertheless, this new concept is reserved for the few cases of strictly
limited disease and must be controlled by future studies.
Key words
Small-cell lung cancer - Surgery - Chemotherapy
