[Extended resection for lung cancer]

Only one third of the patients with lung cancer can be identified as operative candidates. For the other two thirds operation was not indicated, because they have advanced lung cancer with distant metastases or locally advanced lung cancer invading neighboring organs. The results of surgery of lung cancer depend on TNM staging. Resection of stage IIIA, IIIB and IV were not indicated because these gave poor 5-year survival rates. However, a few 5-years survivors without any evidence of recurrence of lung cancer have been reported recently. Chest wall resection and tracheal carinal resection became standard operations because they given a 5-year survival rates of 30% and 34% respectively. Left atrium resection also becomes a standard operation with 22% of 5-year survival rate. Resection of superior vena cava is applied for locally advanced cases with or without invasion to the tracheal carina. Resection of vertebra and main pulmonary artery are being tried with careful and exact evaluation of the extent of primary tumor and invading organs using information provided by new diagnostic equipment.