Evidence-based outcomes for patients with non-small cell lung cancer undergoing resection

Surgery plays a vital role in the management of Stages I-IIIa NSCLC. Careful patient selection and improved perioperative care now allow pulmonary resection to be performed with a very low morbidity and mortality even in older patients, or in patients undergoing pneumonectomy or extended operations. Most patients with Stage IIIb disease are not candidates for surgery, but resection can be curative for highly selected groups of patients with T4 tumors when these are not associated with nodal metastases. Surgery in conjunction with induction chemotherapy or chemoradiation has become a standard approach to the management of Stage IIIa (N2) disease and, in that setting, can be performed safely and effectively. The role of surgical resection in the treatment of NSCLC will undoubtedly continue to evolve as we gain a better understanding of the biology and multimodality therapy of this disease.