Quality of life (QOL) versus curability for lung cancer surgery

Standard operations for lung cancer patients are generally accepted as performing lobectomy or pneumonectomy on the tumor bearing lung and ipsilateral hilar and mediastinal lymphadenectomy including subcarinal lymph nodes. Recently, minimally invasive surgery or limited resection (for example, those via VATS) has ruled our time in the field of surgery considering especially from the point of QOL. There are so many factors that cause any decline to lung cancer patients' postoperative QOL, such as operative death, postoperative cancer death, postoperative complications, long-lasting discomfort symptoms and so forth. However, a surgery, even though it is big or extensive, does not always inevitably reduce QOL for patients with lung cancer. If patients received curable resection and have got cured, it seems that they would almost all be satisfied with their postoperative QOL. Namely, at present, we do not give priority to QOL but we should give priority to curability for lung cancer surgery, if the patients have no special risk factors, which eventually would bring them almost satisfactory postoperative QOL.