Opinion

Video

Surgical and Radiotherapy Choices in Limited-Stage SCLC

Author(s):

Melissa L. Johnson, MD,Wade T. Iams, MD

Panelists discuss how the surgical approach to limited-stage small cell lung cancer varies, including the percentage of cases amenable to resection, the preference for lobectomy in stage I-IIA disease, and the role of mediastinal lymph node staging in shaping treatment strategies, alongside considerations for choosing between surgery and radiotherapy, the selection of systemic treatments, and the integration of prophylactic cranial irradiation in treatment plans.

Video content above is prompted by the following:

  • In your experience, what percentage of limited-stage disease is amenable to resection and does lobectomy remain the preferred procedure for stage I-IIA (T1-2, N0, M0) disease?
  • How often does a surgeon operate on a small cell nodule, and what is the next step in treatment? 
  • To what degree does mediastinal lymph node staging influence your treatment path?

2. Under what circumstances would surgery vs radiotherapy (SABR ) be a preferred, definitive treatment choice for a patient with stage I-IIA small cell lung cancer (SCLC)? 

  • How do you approach frontline therapy?
  • What factors inform your decision to select systemic treatment and concurrent radiotherapy vs sequential radiotherapy?
  • How does prophylactic cranial irradiation factor into your treatment plan for patients with limited-stage SCLC?
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