How do you approach early stage, mixed histology lung cancer (SCLC and NSCLC components) in patients with good performance status?

Certainly the simplest approach for an early stage mixed SCLC/NSCLC would be upfront surgical resection and node dissection (provided that good performance status implies medical operability), and then pathologically if a true small cell component is confirmed (or if the patient is found to be node positive on LND) would treat with adjuvant Etoposide and Cisplatinum x 4 cycles. There is perhaps a debate on PCI for early stage SCLC (included in randomized trials and Auperin meta-analysis which sh...

We published our experience (Babakoohi et al. Clinical Lung Cancer 2013) with combined small cell carcinoma (meaning both a small cell and non-small cell component). In over 400 patients with small cell we found 22 patients with combined small cell. The outcome of combined small cell is overall better than pure small cell with many patients diagnosed in early stage such as the case in question here. Our data suggests that the outcome with surgery is excellent in early stage combined small cell. ...