[Primary lung cancer]

With the recent increase of lung cancer patients, small sized lung cancers are frequently found with the widely using of computed tomography (CT). In November 2010, National Cancer Institute announced that the routine medical examination with using low dose helical CT reduced the lung cancer death rate by 20%, compared with plain chest X-ray. For the small sized lung cancers, several clinical studies for limited surgery and stereotactic radiation therapy are on going now. On the other hand, based on the development of radiation and chemotherapy, treatment results of locally advanced lung cancer are improving. Several studies reported that postoperative adjuvant chemotherapy improved the prognosis by 10-15%. Neoadjuvant chemotherapy or chemoradiotherapy have also been reported to improve the postoperative survival compared with the treatment by surgery alone. Postoperative mortality rate has been decreased to 0.9% according to the recent report from Japanese Thoracic Surgical Society. Like these, surgical treatment for lung cancer has been developed certainly with advancing radiological diagnosis, radiation therapy, chemotherapy, and perioperative management.