The current standard of care for small cell lung cancer (SCLC) remains radiotherapy, and the role of surgical resection in these patients remains controversial. Due to the poor prognosis of SCLC and its very limited indications for surgery, the NCCN guidelines recommend that surgery be considered for patients with early stage non-metastatic SCLC. In view of this, Professor Takei et al. from Japan conducted a retrospective study reporting the prognosis of patients with surgically resected SCLC in Japan in 2004, the results of which were published in a recent issue of JTO. The study collected clinicopathological data on 11,663 patients with primary lung cancer who underwent surgery in 2004 throughout Japan, and included 243 (2.1%) of these patients with SCLC in the study. The investigators analyzed the registry data of SCLC patients and evaluated the clinicopathologic characteristics and surgical outcomes of the patients. The study found that the 5-year survival rate for all patients (N = 243, 213 males, mean age 68.2 years) was 52.6%. 5-year survival rates corresponded to the following C- and P-stages: IA, 64.3% and 72.3%; IB, 45.7% and 61.1%; IIA, 50.5% and 44.8%; IIB, 33.3% and 40.3%; IIIA, 30.5% and 23.4%; and IV, 0% and 0%, respectively. and IV, 0% and 0%. Using multifactorial analysis, it was shown that age, gender, C-stage and surgery significantly affected the prognosis of patients. The study showed that surgical resection resulted in a survival benefit for patients with small cell lung cancer, especially for stage I patients who achieved a high 5-year survival rate. The investigators concluded that patients with small cell lung cancer treated with surgery + adjuvant radiotherapy in certain circumstances significantly improved their prognosis. Of course, the current findings are mainly from retrospective studies and need to be confirmed in future prospective clinical randomized controlled trials.