7585 Background: Small cell lung cancer (SCLC) rarely presents as I/II Disease. In order to assess the incidence, treatment and prognosis of this early-stage SCLC, we used the Surveillance, Epidemiology and End Results database. Furthermore, since some investigators are irradiating growing and/or PET Scan positive nodules without biopsy, presenting characteristics of surgically-resected Stage I SCLC were compared to those of non-small cell lung cancer (NSCLC). Methods: The SEER 17 Database from 1988–2003 was accessed for all patients with early-stage SCLC. Presenting characteristics of surgically-resected Stage I SCLC were compared to those of resected Stage I NSCLC using chi-square and Wilcoxon Rank Sum tests. The logrank test was used to compare the differences in Survival(S) resulting from the various treatments options for early-stage SCLC. Results: 1,615 patients were identified with early-stage SCLC with greater than 3 months of follow-up. The median S was 20 months for the entire group. Over the time period of our study, the incidence of early stage SCLC as a percentage of all SCLCs and all lung cancers (SCLCs and NSCLCs) remained stable and ranged from 3.00–4.96% and 0.09–0.16% respectively. Surgically-resected Stage I SCLC did not differ from NSCLC in regards to patient characteristics (age, sex, race) or tumor location, but SCLC was found to have significantly smaller tumor size (p< 0.0001). Lobectomy or greater resections without radiotherapy were associated with a greater median S than those treated with segmental/wedge resections and those treated with radiotherapy alone (44 vs 29 months, p=0.03 and 20 months, p <0.0001). Furthermore, when lobectomy or greater resection was performed, adjuvant radiotherapy was associated with a shorter, but not significantly different median S (32 vs 44 months, p = 0.17). Segmental/wedge resections without radiotherapy were associated with significantly better S than patients who received radiotherapy alone, but no difference in S was found with the use of adjuvant radiotherapy (29 vs 20 months, p =0.003, and 35 months, p=0.31). Conclusions: The incidence of stage I/II small cell lung cancer was stable over the years of our study. Anatomic lobectomy without adjuvant radiotherapy appears to be the optimal therapy for patients without mediastinal nodal metastases. No significant financial relationships to disclose.