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Ann Thorac Surg 1992;54:493-497
© 1992 The Society of Thoracic Surgeons

Articles

Multimodal therapy of small cell lung cancer in TNM stages I through IIIa

Ludwig C. Müller, MD*,a,b, Georg M. Salzer, MDa,b, Heinz Huber, MDa,b, Christian Prior, MDa,b, Ingrid Ebner, MDa,b, Hermann Frommhold, MDa,b, Heinz-Wolfgang Präuer, MDa,b

a Division of Thoracic Surgery, Department of Surgery II, Policlinic for Hematology and Oncology, Department of Internal Medicine, and Department of Radiotherapy, University of Innsbruck, Austria
b Division of Thoracic Surgery, Klinikum Rechts der Isar, Munich, Germany

Accepted for publication December 30, 1991.

* Address reprint requests to Dr Müller, II Univ. Klinik f. Chirurgie, Abt. f. Thoraxchirurgie, Anichstraβe 35, A-6020 Innsbruck, Austria.

Since 1977, Innsbruck University Hospital has been employing a multimodal therapy concept for small cell bronchial carcinomas in stages I to IlIa. This concept includes all three treatment forms effective in this tumor, namely, chemotherapy, surgery, and radiotherapy. The therapy scheme is stage-dependent and begins in stages T1–3 NO-1 with lung resection and in stage N2 with chemotherapy. To date, 45 patients have been included in a prospective, nonrandomized (phase II) trial: 7 in TNM stage I, 11 in stage II, and 27 in stage IIIa (6 T3 and 21 N2). The actuarial 5-year survival rate of the entire group (including therapy-related lethality, early recurrences, and protocol violations) is 36%; it is 57% for those in stage I, 28% for those in stage II, and 34% for those in stage IIIa. Median survival time is 18 months. Patients with completed multimodal treatment have a 5-year survival rate of 56% regardless of disease stage. Three patients died of tumor-unrelated causes after 47, 52, and 54 months.




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