Surgery or chemoradiotherapy for early-stage small cell lung cancer (SCLC)? A study conducted by Professor Henrik M?ller and others from King’s College London Cancer Centre, Cancer UK, suggests that selective surgical treatment may result in survival benefits for SCLC patients. The findings were published online in the October 30, 2013 issue of Thorax. Chemotherapy or radiotherapy is the recommended treatment option for small cell lung cancer (SCLC), and clinical guidelines suggest that surgery may provide a survival benefit for stage I patients based on a series of favorable outcomes. Evidence supporting postoperative adjuvant chemotherapy for SCLC is limited but widely accepted, yet data on surgical treatment of SCLC remain relatively scarce. This study retrospectively analyzed data from 359,873 patients diagnosed with primary lung cancer in the United Kingdom between 1998 and 2009 and grouped according to histology small cell lung cancer (SCLC) or non-small cell lung cancer (NSCLC)) and whether they underwent surgical resection. Their survival was explored using Kaplan-Meier analysis and Cox regression analysis adjusting for age, sex, comorbidities and socioeconomic status. The results of the study found that 465 patients with surgically resected small cell lung cancer had significantly lower survival times than patients with surgically resected non-small cell lung cancer (5-year survival rates of 31% and 45%, respectively), but much higher than any group of non-surgically resected patients (3%). Over time, the difference between surgically resected small cell lung cancer and non-small cell lung cancer decreased. 198 cases of “elective” small cell lung cancer with a clear preoperative diagnosis had better survival than 267 cases of small cell lung cancer found “incidentally” after surgery. This study suggests that the survival outcomes of patients with surgically treated early-stage small cell lung cancer may be close to those of non-small cell lung cancer and should support the provision of surgical treatment for elective SCLC patients.