Ⅱ-ⅢA Stage Small Cell Lung Cancer Surgery Clinical Research

ObjectiveBy comparing the outcome of surgical resection combining with chemo-radiotherapy and simply chemo-radiotherapy,this study evaluate the role of surgical resection in the treatment of stage II-IIIA SCLC.MethodsWe analyze the database of 902 SCLC patients received in CICAMS from January 2004 to December 2011 retrospectively.Of 268 cases are II-IIIA stage.Surgical resection were performed in 129 of them, the rest of 139 case are treated without surgery. They both received chemotherapy, the chemical regimen includedetoposide+cis-platinum (PE) or carboplatin+etoposide (CE) 2-10 cycles, small part of them received cyclophosphamide+doxorubicin+cis-platinum (CAP) or cyclophosphamide+ vincristine+pharmorubicin (COA) 2～10 cycles. The resection gave priority to radical resection including lobectomy and bilobectomy (75.97%), a small part of it was palliative resection (wedge resection)(7.75%). Part of patients were treated with thoracic irradiation and prophylactic cranial irradiation (PCI), with sequential chemotherapy.ResultsIn surgery group, the 1 year,2 years,3 years and 5 years survival rates were 90.70%、70.54%、52.71% and 33.78%(25/74).In non-surgery group, the 1 year,2 years, 3 years and 5 years survival rates were 82.73%.58.27%、43.17% and 25.35%(18/71). Failure in both group included local recurrence,distant metastasis and brain metastasis.By analyzing the database with Kaplan Meier survival analysis, the surgical group had better prognosis than the non-surgical group.We analyzed sex, family history, smoking, age and pathological type as prognostic factorsto get the patients’prognosis.ConclusionIn stage Ⅱ-ⅢA SCLC patients who is suitable for surgical resection,the operation therapy would benefit the patients,combining with chemotherapy and radiotherapy would achieve a satisfactory treatment result.Sex,family history, smoking,age and pathological type cannot affect the prognosis.