Abstract
Surgery in the treatment of small cell lung cancer (SCLC) was commonplace up until the mid-1970’s when the results of the medical research council (MRC) trial compared surgery to radiation and found no improvement with the addition of surgery. A later trial compared chemoradiation with adjuvant surgery to chemoradiation alone also failed to show an improvement with surgery. These two results have been used to justify nihilism amongst thoracic oncologists with respect to the use of surgery. However, modern screening, staging, minimally-invasive surgery and adjuvant therapy have changed the situation for the treatment of early SCLC. Modern evidence, albeit retrospective, supports a greater utility for surgery in the treatment of early SCLC than what may have been suggested by older randomized trials that are no longer applicable in the modern era. Surgery has much to offer in the treatment of early SCLC and this lecture will outline the potential utility of surgery - in particular anatomic resection and systematic lymph node dissection - as part of a multimodality treatment regimen. small cell lung cancer, Thoracic Surgery
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