The following is the summary of “Pathological Stage N1 Limited-Stage Small-Cell Lung Cancer Patients Can Benefit From Surgical Resection” published in the January 2023 issue of Clinical Lung Cancer by Yu, et al.

Limited-stage small-cell lung cancer (LS-SCLC) is controversial for surgical treatment (except for T1-2, N0M0). The purpose of this research was to determine how long individuals with LS-SCLC who had metastases to their proximal lobe (N1) survived after surgery and subsequent adjuvant therapy. A total of 68 patients with pathological stage N1 (p-N1) who underwent surgical resection and 71 patients with clinical stage N1 (c-N1) who received chemoradiotherapy were included in the final study, covering the time period from June 2007 to June 2016.

All patients were followed for a median of 99.30 months. The median disease-free survival (DFS) in the surgical group was 13.56 months, and the median overall survival (OS) in the surgical and chemoradiotherapy groups was 29.600 months and 21.133 months, respectively (P<.001 for both). Compared to the 39.8% and 9.4% survival rates seen in the chemoradiation group 2 and 5 years after treatment, the surgery group’s success rate was 55.9% and 33.7%. 

Prophylactic cranial irradiation in the surgery group was related to a longer survival time (50.867 vs. 22.600 months, P-value .007), and postoperative thoracic radiotherapy seemed to improve outcomes (median OS 36.400 vs. 21.333 months, P-value .048). Patients with p-N1 SCLC may benefit from surgery, and when combined with effective adjuvant therapy following surgery, surgery may represent a novel therapeutic strategy for SCLC.