Japanese Journal of Clinical Oncology 16:297-307 (1986)
© 1986 Foundation for Promotion of Cancer Research
research-article |
A Clinico-Pathological Study of Surgical Treatment for Small Cell Carcinoma of the Lung
Department of Surgery, Tochigi Cancer Center
*Department of Surgery, National Cancer Center Hospital
**Department of Pathology National Cancer Center Research Institute
Reprint requests: Naoto Miyazawa, M.D., Department of Surgery, Tochigi Cancer Center, 9-13, Yonan, Utsunomiya, Tochigi, Japan.
Received July 8, 1986; Thirty-seven patients with histologically confirmed small cell carcinoma (SCLC), who underwent surgical resection at the National Cancer Center Hospital between 1963 and 1983, were reviewed. They were divided into two groups, 25 patients who were operated on between 1963 to 1979 and 12 who were operated on between 1980 and 1983. When these two groups were compared, a significant difference in 5-year survival was found (8% vs 50%). An accumulation of various factors including adjuvant chemotherapy was considered to contribute to the improvement in survival. After carefully analyzing these factors, we have come to the conclusion that adjuvant chemotherapy was the most important factor among them. An additional six patients with SCLC, who were operated on in 1984 and 1985, were also studied. They were either those who were given an adequate dose of combination chemotherapy before surgical resection or those whose local carcinoma which recurred after complete response was achieved by chemotherapy and/or chest radiation was surgically removed. In two cases, a tumor-like mass which was clearly visible on X-ray film- and in the surgeon's hand at the time of thoracotomy revealed a histo pathological "cure." In another two cases, tissue diagnosis of SCLC which was obtained without thoracotomy before chemotherapy and/or radiation was started was reported as NSCLC after the resected specimen was histo-pathologically examined. In both of them, the cancer tissue was made up of NSCLC of small cell type. A discrepancy between clinical TNM after treatment and pathological TNM was noted in two cases. Microinvasion and micrometastases, which were the reasons for the discrepancy, are considered to be a core of eventual recur rence following induction of complete response.
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