Surgery for Stage III Non-Small Cell Lung Cancer

The management of stage III non-small cell lung cancer has changed dramatically during the past ten years. Some stage IIIA tumors (T3, N0-1) are still treated primarily by surgical resection, but tumors with ipsilateral mediastinal nodal involvement (stage IIIA, N2) are now usually managed with induction chemotherapy or chemoradiotherapy, followed by surgical resection. Most stage IIIB (T4 or N3) tumors, previously treated with radiation alone, are now treated with combined radiation and chemotherapy. The treatment of patients with stage III non-small cell lung cancer continues to evolve, but the expanded use of combined modality therapy appears to have significantly improved the long-term survival of these patients.