Bronchogenic small cell carcinoma

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you are correct, surgery does not improve outcomes. SCLC is highly malignant and even small cancers will also have occult mets. plus SCLC is exquisitely sensitive to chemoradiotherapy, which explains why the only staging that's done is related to how easily irradiated the primary tumor is.
 
70% of patients with SCLC initially present with metastatic disease. It's notorious as a cancer with early metastasis.
 
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