The effects of surgical resection in the treatment of limited-stage small cell lung cancer: a multicenter retrospective study

• Published in: Updates in surgery Vol. 76; no. 4; pp. 1483 - 1492
• Main Authors: Li, Hezhi, Song, Lingmeng, Zhou, Yu, Ye, Jun, Xie, Guoping, Lu, Yuhai
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.08.2024
• Subjects: Medicine; Medicine & Public Health; Original Article; Surgery; Surgical resection; Small cell lung cancer; Multimodality treatment; Lobectomy; Concurrent chemoradiotherapy
• ISSN: 2038-131X; 2038-3312; 2038-3312
• DOI: 10.1007/s13304-023-01708-z

This study aimed to examine the effects of surgical resection on the treatment of limited-stage small cell lung cancer and identify patient characteristics that may indicate a benefit from surgical resection. We retrospectively reviewed medical data from patients diagnosed with small cell lung cancer between January 2013 and December 2020 at three hospitals. A total of 478 patients were included in the study, 153 patients received surgery treatment and 325 patients received non-surgery treatment. Survival differences between the surgical resection group and the nonsurgical resection group were analyzed using the Kaplan–Meier method and the log–rank test. The overall survival in the surgical resection group was significantly improved compared to that in the nonsurgical resection group (HR: 0.58, 95% CI: 0.370–0.876, p  = 0.0126). Surgical resection significantly improved overall survival compared to nonsurgical resection in stage I disease (HR: 0.56, 95% CI: 0.34–0.94, p  = 0.029) and stage IIA disease (HR: 0.60, 95% CI: 0.40–0.92, p  = 0.019). However, no significant differences in overall survival were found between surgical resection and nonsurgical resection in stage IIB disease (HR: 0.86, 95% CI: 0.57–1.29, p  = 0.46) and stage III disease (HR: 0.99, 95% CI: 0.71–1.39, p  = 0.97). The overall survival of patients who underwent lobectomy was significantly better than that of patients who underwent sublobular resection (HR: 1.85, 95% CI: 1.15–4.16, p  = 0.021) and who underwent pneumonectomy (HR: 2.04, 95% CI: 1.29–5.28, p  = 0.009). Surgical resection should be recommended for patients diagnosed with stage I-IIA SCLC. When deciding on the surgical type, it is preferable to choose lobectomy over sublobar resection or pneumonectomy.