Non-small cell lung cancer: pulmonary parenchyma resection in lung-compromised patients

Surgery remains the primary curative treatment for patients who have early-stage non-small cell lung cancer (NSCLC). The proper use of surgical resection depends on a careful assessment of the extent of disease and the cardiopulmonary function. Because lung cancer is more common in patients who have chronic obstructive pulmonary disease (COPD), it is important to select carefully those patients who can safely undergo potentially curative therapy, thereby minimizing postoperative morbidity and mortality. This article discusses the preoperative pulmonary assessment for patient selection, the preparation of high-risk patients, special surgical considerations, and patient management in the immediate postoperative period.