Adding chemotherapy to surgery prolonged life in some lung, neuroendocrine cases

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Perioperative chemotherapy may benefit persons with resected small-cell lung cancer (SCLC) or large-cell neuroendocrine carcinomas (LCNECs), indicates a retrospective analysis conducted in France and presented in Journal of Thoracic Oncology (2012;7[7]:1179-1183), which is published by the International Association for the Study of Lung Cancer (IASLC).

The review of patients who had undergone surgery for limited-stage SCLC or LCNEC showed that 45 had surgery combined with perioperative chemotherapy and 29 had surgery only. Eleven patients in the surgery-plus-chemotherapy group and four in the surgery-only group had LCNEC, which has characteristics similar to those of SCLC. Ten node-positive tumors and two incomplete resections were noted in the surgery group, compared with 27 node-positive tumors and three incomplete resections in the other patients.

Median follow-up was shorter for the surgery-only patients, at 4.5 years vs 5.8 years. Among the patients with a survival or a follow-up of at least 6 months, median survival was 2.3 years among 20 surgery patients, compared with a significantly longer 6.1 years for the 39 people who had surgery plus chemotherapy.

As noted in a statement from the IASLC, SCLC represents about 15% of all lung cancer cases annually. Approximately 30% of the members of that subset have limited-stage disease. Surgery in those patients as well as in persons with LCNEC is so rare that the investigators believe a prospective trial is unlikely to be feasible; therefore, these retrospective data may be of value despite the study's small size and other limitations.

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