[Radical treatment by the surgeon and reality of the pathologist]

The aim of the radical resection of lung tumors is curative treatment. However, in each lung tumor of more than 2 cm in diameter an angioinvasion of tumor cells could be proved by morphological means. Frequently, the existence of lymph nodes and especially hematogenic dissemination is underestimated at the time of resection. By pathological-anatomical means in 33% of T1/T2-N2 and 60% of T1/T2-N3 lung tumors, disseminated tumor cells or organoid metastasis in the bone marrow can be demonstrated. Therefore, the demand for radicalness of the surgeon does not agree with a curative tumor therapy in more advanced tumor stages. Actually, the course of the disease following a local radical resection is predominantly predetermined by the individual hematogenic metastatic spread.