Surgical treatment of non-small cell lung cancer by stage

Resection is the treatment of choice for stage I and II non-small cell lung carcinoma. The 5-year survival following resection is 72% in stage I carcinoma and 49% in stage II carcinoma. Resection alone or combined with radiation and/or chemotherapy is also indicated in some patients with stage IIIa disease. The 5 year survival with resection is 56% in tumors invading chest wall (T3N0), 30% in superior sulcus tumors, 30% in patients with N2M0 disease, and 36% in patients with tumors in proximity to carina. Surgery is of very limited value in patients with tumors invading the mediastinum and in patients with stage IIIb or stage IV disease. Details of case selection in each treatment category are presented.