caa a22 4500 475754107 CHVBK 20180406123533.0 cr unu---uuuuu 170329e20001101xx s 000 0 eng 10.1007/s005950070017 doi (NATIONALLICENCE)springer-10.1007/s005950070017 The Significance of Surgery for Bulky N2 Small-Cell Lung Cancer: A Clinical and In Vitro Analysis of Long-Term Survivors [Elektronische Daten] [Shunsuke Kobayashi, Shinichiro Okada, Toru Hasumi, Nobuyuki Sato, Shigefumi Fujimura] Until recently, stage III small-cell lung cancer (SCLC) has not been considered an indication for surgical treatment; however, stable subculture has become possible in about 80% of the patients with SCLC in our hospital. Therefore, we have been performing surgery for all patients with cStage I-III resectable tumors and giving combined-modality therapy based on the sensitivity assay in vitro since April 1982. In the present study, we reviewed 30 consecutive patients with cStage III and pStage III SCLC, including 27 with N2 disease who underwent surgery between 1982 and 1992, 7 of whom (23%) survived disease-free for over 5 years. We examined the cell characteristics in vitro and the actual treatment of five patients with bulky N2 lesions, four of whom were long-term survivors and one of whom died 11 months after surgery, as controls for comparison with the long-term survivors. Based on the results of the cell characteristics in vitro, SCLC was determined to be a heterogeneous tumor. Thus, surgical excision of the primary tumor with adjuvant therapy might be necessary to achieve long-term survival and maintain good performance status, and to improve quality of life in patients with bulky N2 SCLC by eliminating drug-resistant tumor cells within the primary tumor. Springer-Verlag, 2000 Key words Small-cell lung cancer nationallicence Bulky N2 nationallicence Combined-modality therapy nationallicence Long-term survival nationallicence Tissue culture nationallicence Kobayashi Shunsuke Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aoba-ku, Sendai 980-8575, Japan, JP aut Okada Shinichiro Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aoba-ku, Sendai 980-8575, Japan, JP aut Hasumi Toru Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aoba-ku, Sendai 980-8575, Japan, JP aut Sato Nobuyuki Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aoba-ku, Sendai 980-8575, Japan, JP aut Fujimura Shigefumi Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aoba-ku, Sendai 980-8575, Japan, JP aut https://doi.org/10.1007/s005950070017 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s005950070017 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kobayashi Shunsuke Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aoba-ku, Sendai 980-8575, Japan, JP aut NATIONALLICENCE 700 1- Okada Shinichiro Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aoba-ku, Sendai 980-8575, Japan, JP aut NATIONALLICENCE 700 1- Hasumi Toru Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aoba-ku, Sendai 980-8575, Japan, JP aut NATIONALLICENCE 700 1- Sato Nobuyuki Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aoba-ku, Sendai 980-8575, Japan, JP aut NATIONALLICENCE 700 1- Fujimura Shigefumi Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aoba-ku, Sendai 980-8575, Japan, JP aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer