Lung cancer surgery
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- Surgery is the best treatment option for patients with resectable tumors.
- The feasibility of surgery depends on the stage of lung cancer at the time of diagnosis.
- The surgical procedures for lung cancer include:
- Wedge resection (removal of part of a lobe)
- Lobectomy (removal of a single lobe of the lung)
- Bi-lobectomy (removal of two lobes)
- Pneumonectomy (removal of an entire lung)
- Sleeve resection
- The overall operative mortality rate even after careful patient selection is about 4.4%.
- The patient selection for lung cancer depends on:
- In non-small cell lung cancer, the following stages are suitable for surgical resection:
- Stage IA
- Stage IB
- Stage IIA
- Stage IIB
- Surgical intervention is not recommended for the management of lung cancer patients with the following stages:
- Stage IIIA
- Stage IIIB
- Stage IV
For more information on staging, please visit non-small cell lung cancer staging.
- A sufficient preoperative pulmonary reserve must be present to allow adequate lung function after the tissue is removed.
- Pulmonary reserve is measured by spirometry.
- The preoperative physiologic evaluation established by the American College of Chest Physicians for patients with lung cancer for surgical resection include:
- Measurement of FEV1 and carbon monoxide diffusion capacity (DLCO).
- Surgery is contraindicated if spirometry reveals poor respiratory reserve which is often due to underlying chronic obstructive pulmonary disease (COPD).
- El-Sherif, A (Aug 2006). "Outcomes of sublobar resection versus lobectomy for stage I non-small cell lung cancer: a 13-year analysis". Annals of Thoracic Surgery. 82 (2): 408–415. PMID 16863738. Unknown parameter
- Fernando, HC (Feb 2005). "Lobar and sublobar resection with and without brachytherapy for small stage IA non-small cell lung cancer". Journal of Thoracic and Cardiovascular Surgery. 129 (2): 261–267. PMID 15678034. Unknown parameter
- Strand, TE (Jun 2007). "Risk factors for 30-day mortality after resection of lung cancer and prediction of their magnitude". Thorax. BMJ Publishing Group Ltd. PMID 17573442. Unknown parameter
- Mountain, CF (1997). "Revisions in the international system for staging lung cancer". Chest. American College of Chest Physicians. 111: 1710–1717.
- Brunelli A, Kim AW, Berger KI, Addrizzo-Harris DJ (2013). "Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines". Chest. 143 (5 Suppl): e166S–90S. doi:10.1378/chest.12-2395. PMID 23649437.
- Schirren, J (1995). "Surgical treatment and results. Carcinoma of the lung". The European Respiratory Monograph. 1 (1): 212–240. Unknown parameter