[Multidisciplinary treatment of lung cancer: 2008]

There have been no changes in the treatment policy of our university for lung cancer during the past 25 years, i.e.: (1) to perform surgery consisting of "lobectomy and hilar and mediastinal lymph node dissection" regardless of the clinical stage, (2) to perform postoperative adjuvant chemotherapy regardless of the postoperative stage, and continue the chemotherapy on an outpatient basis, and (3) to perform postoperative radiation therapy when mediastinal lymph node metastasis is detected histologically. The original intention was to modify this policy any time apprehension was sensed toward this basic approach, but in the end that was unnecessary. In terms of technique, starting 24 years ago we performed surgery by thoracotomy with unilateral lung collapse (surgery by one-lung ventilation), mainly by using the Univent, and the duration of the operation was greatly shortened. Twelve years ago we began performing surgery mainly for clinical stage IA lung cancer by the thoracoscopic 2 window method that was developed at our university. At present the 5-year survival rates in studies of cases followed up for 5 years or more have been : IA, 94.0%, IB, 87.5%, IIA, 85.7%, IIB, 50.0%, IIIA, 69.6%, IIIB, 16.7%, and IV, 33.3%. The current results have been satisfactory.