Surgical treatment of lung cancer

The prognosis for carcinoma of the lung is influenced by the stage of the disease at presentation and by the potential for resectability. The five-year survival rate following resection of stage I carcinoma is as high as 83% for T1N0 lesions and about 65% for T2N0 tumors. Some stage III tumors are also amenable to surgery in the absence of distant metastases. N2 disease tends to be refractory to cure, despite a localized presentation; however, 20% of patients with N2 disease have resectable tumors despite the presence of lymph node metastases, with a 5-year survival rate of 30% following surgery and postoperative external radiation therapy. Surgery is not beneficial for patients with small cell lung cancer. Proper case selection and careful preoperative and perioperative management are necessary to minimize complications.