Lege Artis Medicinae

[Modern surgical treatment of lung cancer]

AGÓCS László

MARCH 21, 2008

Lege Artis Medicinae - 2008;18(03)

[Lung cancer is one of the most malignant human cancers because of its high incidence and high mortality rate. The 5-year relative survival rate for lung cancer at the initial diagnosis is 5-15%. Stage I or stage II non-small cell lung cancer (NSCLC) are considered early stage disease. Unfortunately, these two stages combined account for only 25 to 30% of tumours at the initial detection. At present, surgical resection remains the recommended treatment for patients with stage I and II NSCLC. Despite negative preoperative staging studies including mediastinoscopy, as many as one fourth of the patients will be found at surgery to have an occult N2 or one nodal station positive metastatic – stage IIIA – disease. Multimodality therapy is preferred for all subsets of stage IIIA patients. In stage IIIB and IV, surgical resection is possible and indicated only in selected cases, including Pancoast tumours, T4N0,1M0 tumours, the presence of satellite nodules in the same lobe, and certain solitary metastases. Patients with clinical stage T1-2 N0 small cell lung cancer (SCLC) may benefit from surgery for confirmation of diagnosis and improved local control when combined with chemotherapy. The mortality and morbidity rates of surgery in the treatment of lung cancer are reasonably low.]

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