Anatomical lung resection after neoadjuvant chemoradiotherapy.

Area of Science:

• Thoracic surgery
• Surgical oncology
• Medical oncology
• Radiation oncology

Background:

• Anatomical lung resection is standard for Stage I and II non-small cell lung cancer (NSCLC).
• The role of surgery in Stage III NSCLC, particularly with N2 spread, remains less established.
• Multimodality treatment approaches are gaining acceptance for locally advanced lung cancer.

Purpose of the Study:

• To define the evolution of surgical integration into Stage III NSCLC treatment algorithms.
• To emphasize the neoadjuvant chemoradiotherapy followed by resection strategy.
• To present evidence supporting surgery's role in trimodality therapy for advanced NSCLC.

Main Methods:

• Review of the evolution of treatment strategies for Stage III NSCLC.
• Emphasis on the neoadjuvant chemoradiotherapy followed by surgical resection paradigm.
• Outline of a center's specific strategy for delivering trimodality care.

Main Results:

• The integration of surgery into multimodality treatment for Stage III NSCLC has evolved significantly.
• Neoadjuvant chemoradiotherapy followed by resection is a key component of modern treatment schemas.
• Evidence supports the therapeutic value of this trimodality approach in selected patients.

Conclusions:

• Surgery plays an evolving and important role in the trimodality treatment of Stage III NSCLC, particularly with N2 disease.
• Neoadjuvant chemoradiotherapy followed by resection is a viable and effective strategy.
• Successful and safe delivery of trimodality care requires a comprehensive and integrated approach.