[The combined treatment with surgery and chemotherapy: primary approach to small cell lung carcinoma (SCLC)].

Forty cases of small cell lung carcinoma (SCLC) treated with surgical and chemotherapeutic combined therapy were reported. There were 28 males and 12 females in the group, most with history of more than 2 months, ranging in age of 27-66 years old. Cough, bloody sputum, low fever and chest distress are the main clinical manifestation. The small cell undifferentiated carcinoma was confirmed by fiberbronchoscope examination and pathology in all patients. Single lobectomy was performed in 20 cases, lobectomy of the upper and middle lobe in 9 cases, (sleeve resection of the lobarbronchus in 3 cases), and total pneumonectomy in 7 cases. Two cases were of stage I, 18 were of stage II, and 20 were of stage IIIa. Twelve patients received chemotherapy after operation, and 28 patients underwent the "chemotherapy-operation-chemotherapy" treatment model. Adriamycin (or CDDP), cytoxan, vincristin, and dexomathasone were used for the chemotherapy procedure. The 1, 3, 5-year survival rate of chemotherapy after operation and chemotherapy-operation-chemotherapy group were 70%, 45%, 30.5% and 54%, 30% and 22%, respectively. It is demonstrated that the long-term survival rate could be elevated in SCLC patients treated with chemotherapy after surgical operation, and the chance of operation also could be elevated by preoperative chemotherapy. The resection rate was 93% in the preoperative chemotherapy group.