Non small cell lung cancer surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]


Overview

Surgery is the mainstay of therapy for early-stage non-small cell lung cancer. Common surgical procedures for the treatment of non-small cell lung cancer, include: lung resection with lobectomy, lung resection with pneumonectomy with or without lymph node dissection. The preferred surgical procedure is thoracotomy with removal of the entire lung or lobe (lobectomy) along with regional lymph nodes and contiguous structures.

Surgery

  • Surgical resection is not recommended among patients with advanced or metastatic non-small cell lung carcinoma
  • Surgical staging of the mediastinum is considered standard if accurate evaluation of the nodal status is needed to determine therapy.
  • Surgical treatment consists of a thoracotomy with removal of the entire lung or lobe along with regional lymph nodes and contiguous structures.
  • In non-small cell lung cancer, surgical procedure selection will depend on the histology, margins, and size of the tumor. Usually, lobectomy is usually the surgical procedure of choice.
  • Pneumonectomy is used if the tumour involves the main bronchus, extends across a fissure or is located such that wide excision is required.
  • Survival following ‘curative’ resection is approximately 30% at 5 years and 15% at 10 years.
  • The best results are found in squamous cell carcinoma followed by large-cell carcinoma and the adenocarcinoma.
  • Surgery is not the first-line treatment option for patients with advanced non small cell lung cancer
  • Lobectomy is usually reserved for patients with the following characteristics:


Complications

References


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