title: The role of surgery for locally advanced non-small cell lung cancer.
abstract: Accurate clinical staging of patients with locally advanced non -small cell lung cancer (NSCLC) is critical in identifying surgical candidates, who are typically patients with stage N2 disease. Preoperative staging by 18(F)-fluorodeoxyglucose-positron emission tomography can alter staging and therefore influence the selection of therapy. The staging evaluation should include an assessment of the mediastinal lymph nodes; mediastinal lymph node involvement is a negative prognostic indicator. When the treatment plan potentially includes surgery, multidisciplinary evaluation including physiologic evaluation is essential, as surgery is aggressive with potential morbidity. Multimodality therapy offers the best chance for improved progression-free and overall survival. Patients with potentially resectable NSCLC who are downstaged following induction chemotherapy have a superior prognosis compared with those whose stage is unaltered.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. masond2@ccf.org
authors.forename: David P
authors.initials: DP
authors.lastname: Mason
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D000069347:Erlotinib Hydrochloride; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D064847:Multimodal Imaging / Q000379:methods; D009367:Neoplasm Staging / Q000379:methods*; D017239:Paclitaxel / Q000008:administration & dosage; D049268:Positron-Emission Tomography; D011379:Prognosis; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage; D011799:Quinazolines / Q000008:administration & dosage; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
chemical_list: D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D019788:Fluorodeoxyglucose F18; D016190:Carboplatin; D000069347:Erlotinib Hydrochloride; D017239:Paclitaxel