Surgery for local recurrence after complete response had been obtained by chemoradiotherapy for small cell lung cancer

Background. Standard therapy for small cell lung cancer is considered to be chemoradiotherapy, and a role of surgery is limited. Case. A 44-year-old man was admitted with hemoptisis. Since small cell carcinoma of the lung in the right lower lobe was diagnosed, he underwent concurrent chemo-radiotherapy (cisplatin + etoposide + 45 Gy) and additionally 3 courses of chemotherapy (cisplatin + etoposide + irinotecan). Diagnostic imaging indicated a complete response with images, but 20 months later, local recurrence was diagnosed. After 1 course of chemotherapy (cisplatin + irinotecan), complete response was achieved and he has underwent one more course of chemotherapy. Because the disease-free interval was 20 months and his recurrence seemed limited to the original site, he underwent salvage surgery (right middle and lower lobectomy). Viable cancer cells were confirmed in the resected specimen. He is alive without any recurrence four years after surgery. Conclusion. This case makes us reconsider the role of salvage surgery for recurrent small cell lung cancer.