[Surgical strategy for stage III non-small cell lung cancer; a review based on our experience and the literature].
We reviewed our experience and the literature to clarify the resection indication and pre-/postoperative treatment for stage III non-small cell lung cancer. Surgery alone should not be applied to patients with stage IIIA non-small cell lung cancer except for clinical T3N1M0 cases. An indication of pulmonary resection for clinical T1-3N2M0 cases should be added to preoperative induction therapy, such as chemo-or chemoradiation therapy. Postoperative N2 cases, which were diagnosed as N0-1 disease preoperatively, should be treated with some additional adjuvant therapy. The prognosis of patients with induction therapy following surgery is almost equal to those with chemoradiation alone for clinical N2IIIA disease. In recent years,adjuvant chemotherapy is recognized as the standard treatment for postoperative N2IIIA disease with curative resection. Some hold that there is no operable indication for stage IIIB diseases. However, some cases with satellite lesions in the same lobe of the primary site and with malignant effusion,which are not associated with lymph node involvement or other T4 factor, are reported to have good prognoses after surgery.
Horio
Hirotoshi
H
Department of Thoracic Surgery, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyou-ku, Tokyo 113-8677, Japan.
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011379:Prognosis; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate