Limited-stage small cell lung carcinoma

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Overview of limited-stage small cell lung carcinoma


Limited-stage small cell lung carcinoma[edit | edit source]

Chest CT showing limited-stage small cell lung carcinoma

Limited-stage small cell lung carcinoma (LS-SCLC) is a classification of small cell lung carcinoma (SCLC), a highly aggressive form of lung cancer. In LS-SCLC, the cancer is confined to one side of the chest and can be encompassed within a single radiation field. This stage is distinct from extensive-stage small cell lung carcinoma, where the cancer has spread beyond the chest.

Pathophysiology[edit | edit source]

Histological image of small cell lung carcinoma

Small cell lung carcinoma is characterized by small, oval-shaped cancer cells that proliferate rapidly. These cells are derived from neuroendocrine cells in the lung and are known for their high mitotic index and tendency to metastasize early. The limited-stage designation indicates that the tumor is localized, typically involving the lung, mediastinum, and supraclavicular lymph nodes on the same side.

Diagnosis[edit | edit source]

The diagnosis of LS-SCLC involves a combination of imaging studies, such as chest X-ray, computed tomography (CT) scans, and positron emission tomography (PET) scans, to determine the extent of the disease. A biopsy is essential to confirm the diagnosis, often obtained via bronchoscopy or CT-guided needle biopsy. The histological examination reveals small, round, blue cells with scant cytoplasm, characteristic of SCLC.

Treatment[edit | edit source]

The primary treatment for LS-SCLC is a combination of chemotherapy and radiation therapy. Chemotherapy typically includes platinum-based drugs such as cisplatin or carboplatin, combined with etoposide. Concurrent radiation therapy to the chest is administered to improve local control and survival rates. Prophylactic cranial irradiation (PCI) may be offered to prevent metastasis to the brain, a common site of spread in SCLC.

Prognosis[edit | edit source]

The prognosis for patients with LS-SCLC is generally better than for those with extensive-stage disease, but it remains poor compared to other types of lung cancer. The median survival for LS-SCLC is approximately 15 to 20 months, with a 5-year survival rate of about 20%. Early detection and aggressive treatment are crucial for improving outcomes.

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Contributors: Prab R. Tumpati, MD