Small cell carcinoma of the lung surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Overview
In small cell carcinoma of the lung (SCCL), 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.[1]
Surgery
- 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]
- 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.[1]
- 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 underwent complete resection of the tumor,[2] as long as their performance status is good and they do not have any neurological cognitive impairment.
References
- ↑ 1.0 1.1 1.2 1.3 NCCN Clinical Practice Guidelines in Oncology. Small Cell Lung Cancer, version 2.2014
- ↑ Aupérin A, Arriagada R, Pignon JP, Le Péchoux C, Gregor A, Stephens RJ; et al. (1999). "Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. Prophylactic Cranial Irradiation Overview Collaborative Group". N Engl J Med. 341 (7): 476–84. doi:10.1056/NEJM199908123410703. PMID 10441603.