Principles of surgical treatment in localized non-small cell lung cancer

Non-small cell cancer has become the leading cause of cancer-related deaths in women and men in the western hemisphere. Surgical resection remains the mainstay of therapy in stage I and II disease. Surgical therapy has an acceptable morbidity and mortality rate. Analysis of 5-year survival shows 70-75% in experienced centers for stage I and 40% for stage II, including tumors extending to the chest wall. Local and distant recurrence account for the disappointing survival rates after complete resection. In the future, appropriate selection of surgical procedures and effective use of systemic therapies might depend upon the elucidation of prognostic factors that predict recurrence and poor outcome. Thus, parameters need to be identified that characterize those patients preoperatively.