[Guide line for the treatment of stage I and stage II non small cell lung cancer]

Evidence based treatment modalities should be established as more than 55,000 patients die of lung cancer every year and its number is increasing. For stage I and stage II non small cell lung cancer (NSCLC), surgery is strongly recommended if there are no contraindications such as impaired pulmonary function and other medical disorders. Although lobectomy (bilobectomy or pneumonectomy) with mediastinal lymphnode dissection is standard operation for stage I and stage II NSCLC, limited operation (segmentectomy or extended segmentectomy) for peripherally located small sized cancer (less than 2 to 3) is now being performed to assess if there is survival difference between standard operation. Also numbers of patients undergoing video-assisted thoracoscopic surgery (VATS) is increasing and studies to compare postoperative survival rate and postoperative quality of life with standard operation is performed. To improve postoperative survival, pre and postoperative treatment such as chemotherapy, radiotherapy or combination of these treatments have been undertaken. Very recently usefulness of postoperative adjuvant chemotherapy with Uracil-Tegafur for stage I adenocecinoma was reported from Japan. For patients with stage I and stage II NSCLS in whom operation is not feasible for medical reasons, radical radiation therapy is recommended.