Abstract
BackgroundIt is shown that low-dose computed tomography (CT) screening is useful for a reduction in lung-cancer-specific mortality in heavy smokers. However, the information about effectiveness according to the histological types of lung cancer has not been adequately investigated especially small cell lung cancer (SCLC). The present study was performed to see the clinical benefit of CT screening in patients with SCLC following thoracotomy.MethodsWe retrospectively reviewed the outcome in patients with early stage SCLC who initially underwent thoracotomy. The clinical stages and actuarial survival were estimated according to the three means of detection of SCLC: chest CT, radiographic screen, and symptomatically prompted cases.ResultsSixty-nine patients (men/women, 63/6; mean age, 70 years) with SCLC underwent thoracotomy between 1991 and 2010 including chest CT (n = 13), radiographic screening (n = 39), and symptomatically prompted cases (n = 17). Pathological staging information included stage IA (n = 25), IB (n = 8), IIA (n = 13), IIB (n = 5), IIIA (n = 11), and IIIB (n = 7). Median survival time was 30.0 (95% confidence interval (CI): 22.0 to 57.0) months, with overall survival at 5 years of 34.3% (95% CI, 23.47 to 47.3). Nine patients (69%) with stage I were detected by CT which was significantly higher than those in other detection arms. However, there were no significant differences in the survival between CT and other detection arms.ConclusionsCT examination may be useful for detection in early stage SCLC potentially suitable for surgery, but the contribution to better clinical outcome in patients with SCLC remains unclear.
Highlights
It is shown that low-dose computed tomography (CT) screening is useful for a reduction in lungcancer-specific mortality in heavy smokers
We previously reported six cases with early stage small cell lung cancer (SCLC) detected by CT screening; four of these cases were successfully treated by initial surgical resection [18]
Lobectomy was performed in 53 patients (76.8%), pneumonectomy was performed in three patients (5.0%), and segmentectomy or partial resection was performed in 13 patients (18.8%)
Summary
It is shown that low-dose computed tomography (CT) screening is useful for a reduction in lungcancer-specific mortality in heavy smokers. Small cell lung cancer (SCLC) represents 10% to 15% of all lung cancers [3] and shows a high grade of malignancy with rapid growth and early widespread metastasis. As it is a virulent disease with high metastatic potential, it is usually considered a systemic disease at initial presentation. We previously reported six cases with early stage SCLC detected by CT screening; four of these cases were successfully treated by initial surgical resection [18]. There remains to be a scarcity of data focusing on screen-detected SCLC
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