Surgical Resection as an Adjunct to Chemotherapy for Small Cell Carcinoma of the Lung

Abstract

The second edition of the World Health Organisation’s classification of lung tumours (World Health Organisation 1982) divides small cell carcinoma into three subtypes: oat cell carcinoma, intermediate cell type and combined oat cell carcinoma (see p. 135). Both oat cell and intermediate cell tumours grow rapidly and disseminate widely. Labelling indices are the highest among lung tumours (Muggia and DeVita 1972). It is generally accepted that volume-doubling times are short, with median values in the range of about 23–40 days (Chahinian 1972; Meyer 1973; Bhaskar et al. 1977); one study did report a median doubling time for small cell carcinomas of 77 days (Brigham et al. 1978) but the authors did not give measurements or define their calculations. The discrepancy between these findings is not easily explainable. Considering that median doubling times of all lung cancers have been reported to be in the range of about 80–90 days (Schwartz 1961; Garland et al. 1963; Spratt et al. 1963), one would expect doubling times of this most malignant tumour to be considerably shorter (see pp. 226, 233).