Small cell lung cancer accounts for about 20% of lung cancers and has a poor prognosis because of its high malignancy, short multiplication time and extensive metastasis at an early stage. According to statistics, the median survival time for limited-stage small cell lung cancer is 15-20 months, and for extensive stage is 8-13 months. Nonetheless, aggressive treatment regimens for limited-stage small cell lung cancer can lead to long-term survival goals. Currently, the latest NCCN guidelines recommend surgical resection for patients with early-stage, lymph node-negative small cell lung cancer. The role of surgery in early-stage small cell lung cancer has been controversial, and data on the pattern of patient recurrence after surgery are scarce. With this in mind, Professor Bradly J. Stish and his team from the Mayo Cancer Center conducted a retrospective study and reported on the prognosis and recurrence rates of limited-stage small cell lung cancer, which was published in a recent issue of Clinical Lung Cancer. The article retrospectively analyzed the overall survival and recurrence rates of patients with small cell lung cancer treated surgically at the Mayo Cancer Center from January 1, 1985, to December 31, 2012, using Kaplan-Meier survival curves and COX regression models. The study found a median follow-up of 5.9 years, a 5-year survival rate of 37%, and a 5-year tumor-free recurrence rate of 44%. Intrathoracic recurrence was the most common pattern of tumor recurrence after surgery, with an incidence of 26.9% and a 3-year intrathoracic recurrence-free rate of 64.4%. Patients who underwent lung wedge resection or segmental lung resection had a significantly higher risk of intrathoracic recurrence compared with those who underwent lobectomy or total lung resection. Patients undergoing lobectomy or total pneumonectomy had a higher overall 5-year survival rate compared with wedge or segmental lung resection (48% versus 15%) This study suggests that surgical treatment of carefully screened patients with early-stage small cell lung cancer can have a relatively satisfactory outcome. Intrathoracic recurrence is the most common pattern of postoperative failure. Patients who cannot tolerate lobectomy should be managed with caution because of their relatively high rate of local recurrence, and therefore the addition of postoperative radiotherapy is strongly recommended. Surgery is not recommended for patients with positive clinical stage lymph nodes, and concurrent radiotherapy should be administered. Adjuvant chemotherapy is recommended for all patients with small cell lung cancer.