Treatment of Stage I and II Non-Small-Cell Lung Cancer

Abstract

Staging bias may affect the overall low survival of early-stage NSCLC. However, true stage-specific survival may improve with newer imaging modalities. Future advances, including closed transthoracic radiation, thermal ablative therapy techniques, and gene therapy, may supplant the need to surgically resect these tumors to achieve local control.

Meta-analysis of diagnostic value of 18F-FDG PET or PET/CT for detecting lymph node and distant metastases in patients with nasopharyngeal carcinoma

“…4,5 It is known that stage-adapted therapy significantly improved the survival of patients with cancer. 6,7 In this regard, conventional CT and MRI, mainly providing anatomical information, are performed to assess staging site of NPC, especially for the primary site and localregional metastases. However, owing to the lack of functional information, these modalities are limited in assessment of disease aggressiveness and distant metastases.…”

Major thoracic surgery in octogenarians

“…Radiation therapy does little to improve this survival rate; even with radiation therapy, patients with stage I cancer have a median survival of only 16-25 months [2,3,22]. But, to achieve an adequate resection of a lung cancer, do we have to accept the high risks of thoracotomy?…”

“…In the early 1990s, some investigators claimed that VATS surgery was technically too difficult and that an adequate lymph node dissection was not possible [22]. Since that time, however, several authors have reported that VATS lobectomy with lymph node dissection is technically feasible [13,14,17].…”

“…The access for the VATS technique used has been described previously by our group [13]. In cases of primary lung cancer, a lobectomy was preferred over wedge resection for all but the smallest peripheral lesions, since there are data to support a decrease in local recurrences with lobectomy [5,22]. We also changed to a more anatomical hilar dissection in which the pulmonary vessels were ligated individually, followed by ligation of the bronchus.…”

PET Versus PET/CT Dual-Modality Imaging in Evaluation of Lung Cancer

“…Among the 150 factors that help determine NSCLC prognosis, the tumor stage, as defined by the American Joint Committee on Cancer is considered to be the most important [2,3]. Thus, the choice of therapy options, including surgery, radiation therapy, and chemotherapy-used alone or in combination [4,5]-is based on the tumor stage. Consequently, the accurate determination of tumor size, potential infiltration of adjacent structures, mediastinal lymph node involvement, and the detection of distant metastases are of central importance.…”