Brief report: salvage surgery for patients with local recurrence or persistent disease after treatment with chemoradiotherapy for small cell lung cancer

Abstract Introduction The role of salvage surgery for patients with locoregional (LR) recurrence or persistent small cell lung cancer (SCLC) following radical chemo-radiotherapy (CRT) for limited-stage (LS) disease, is not well established. We evaluated our experience. Methods We conducted a retrospective study of consecutive patients who underwent salvage pulmonary resection for LR-recurrence or persistent SCLC between 2008 and 2020 at the Amsterdam University Medical Center. Results Ten patients were identified. Median age at initial diagnosis of LS-SCLC was 58.5 years (48-71). All patients had radical-intent concurrent CRT. 9/10 patients were diagnosed with LR-recurrent/persistent disease with a median of 18 months (3-78) after CRT. All patients underwent an anatomical radical (R0) resection and mediastinal lymph-node dissection. No 90-day mortality was recorded. One patient developed a LR-recurrence 7 months post-resection. Distant progression was seen in 3 patients 6, 32 and 61 months post-surgery, all of whom subsequently died of progressive SCLC. Median follow-up was 22.5 months (2-86). Disease-free survial was 34 months; overall survival was not reached. Conclusions For highly-selected patients with LR-recurrent or persistent SCLC after CRT, salvage surgery is feasible and can result in clinically meaningful survival. Such patients should be presented to the multidisciplinary tumor board.