The optimal treatment approaches for stage I small cell lung cancer

Lung cancer remains the number one cause of cancer-related deaths in both men and women in the United States with over 220,000 new cases diagnosed annually (1). Out of these, small cell lung cancer (SCLC), a poorly differentiated neuroendocrine tumor, accounts for roughly 10–15% of cases (2). Most patients diagnosed with SCLC have a heavy smoking background and can present with respiratory symptoms or a variety of paraneoplastic syndromes including syndrome of inappropriate antidiuretic hormone secretion, Lambert-Eaton syndrome, or Cushing syndrome (3,4). A key feature of SCLC is its highly aggressive nature with a propensity towards early dissemination. Indeed, the incidence of detecting SCLC at an early stage is extremely low, with up to only 5% of patients presenting with clinical stage I disease after confirmation with mediastinal nodal sampling (5)