Relationship Between Changes in the Histologie Subtype of Small Cell Carcinoma of the Lung and the Response to Chemotherapy

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Abstract
It has been documented that changes in the histopathologic subtype of small cell carcinoma of the lung (SCCL) may occur after chemotherapy. The significance of such changes with respect to response to treatment has not yet been studied. In a retrospective review of 25 patients, we correlated their response from chemotherapy with morphologic changes seen in subsequent histologie material. Eleven patients responded to therapy and 14 failed to respond. A difference in original histologie subtype was found in 10 (71%) of the nonresponders and in only two (18%) of the responders. The difference was statistically significant (p < 0.05). We conclude that patients with “pure” SCCL in the initial biopsy specimen who fail to respond to chemotherapy are likely to have mixed or combined histologie subtypes in subsequent tissue specimens, although we cannot preclude their pre-existence. An attempt to search for different histologie subtypes is warranted in patients who do not respond to chemotherapy regimens considered to be efficacious in SCCL.