{'fraction_non_alphanumeric': 0.03070011231748409, 'fraction_numerical': 0.027704979408461252, 'mean_word_length': 4.808695652173913, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Surgical Resection Of Small-Cell Lung Cancer: Twenty Years Of Experience At University Hospital Center Of São João.

Introduction Small-cell lung cancer (SCLC) includes approximately 15% of all newly diagnosed lung cancers worldwide and is distinguished by its rapid growth rate and early dissemination. Despite advances in the treatment the 5-yearsurvival rate remains low. The National Comprehensive Cancer Network Guidelines (3) reported less than 5% of the patients with SCLC are diagnosed in stage I-IIA. This is the group of patients most likely to benefit from surgery. Lobectomy with mediastinal lymph node dissection is the preferred operation and patients who undergo complete resection should be treated with postoperative systemic therapy. Surgical resection is associated with longer survival and approaches 40% to 50% at 5 years with adjuvant chemotherapy (2). Surgical resection of presumed early SCLC may also be beneficial so as not to miss a mistakenly diagnosed SCLC which may indeed be a NSCLC or mixed neuroendocrine tumor. Objectives We retrospectively reviewed our surgical results between August 2000 to August 2020. Results Eight patients with SCLC were submitted to thoracic surgery (5 lobectomies, 1 pneumectomy and 2 wedge resection). The surgical biopsies were excluded. Six patients were males with a median age of 62 years-old (range 50-79) and 50% had an history of emphysema or COPD. Four patients were active smoker, one was a former smoker and one was a non-smoker (none information was available for the remaining 2 patients). Most of diagnoses was obtained by a transbronchial lung biopsy. The median post-operative length of drainage was 4 (range 1-43) days, and median post-operative length of stay was 6 (range 5-44) days. We reported 3 complications (1 case of non-nosocomial respiratory infection and 2 cases of prolonged pulmonary air leak). All the patients had a complete R0 resection. Only 3 patients had exclusive SCLC in pathological findings (the other 5 were associated with NSCLC). Postoperative staging between I-IIA were find in 62.5% (n=5). All the patients were submitted to adjuvant chemotherapy One patient was submitted to cerebral radiotherapy after the diagnosis of cerebral metastasis. Conclusions The only two patients alive in the present time were submitted to thoracic surgery in June of 2017 and December of 2019. Five of the seven (71%) patients were alive after 1 year of surgery but only one of six (17%) were alive after 5 years of surgery, according to completion of the follow-up. The medium time between date of death and the date of diagnosis was 699 days (range 360-2724 days), less than 2 years.