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General Thoracic and Cardiovascular Surgery
Erschienen in: General Thoracic and Cardiovascular Surgery 9/2014

01.09.2014 | Current Topics Review Article

Surgical management of locally advanced lung cancer

verfasst von: Kohei Yokoi, Tetsuo Taniguchi, Noriyasu Usami, Koji Kawaguchi, Takayuki Fukui, Futoshi Ishiguro

Erschienen in: General Thoracic and Cardiovascular Surgery | Ausgabe 9/2014

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Abstract

Majority of cases of lung cancer are detected at an advanced stage; such patients are usually treated with chemotherapy and radiotherapy, and the prognosis is frequently poor. Surgical resection remains the only reliable curative method for the treatment of lung cancer, and combined resection of the primary tumor and involved neighboring structures is performed when possible in patients with locally advanced disease. In the TNM classification, tumors with direct extrapulmonary extension are subdivided based on the anatomic extent of disease and its potential for surgical treatment: T3 lesions with limited, circumscribed extension are thought to be potentially surgically resectable, whereas T4 tumors with extensive extension are considered unresectable. Although surgical treatment for T3 lesions is generally accepted, the outcome is frequently not satisfactory. On the other hand, advanced surgical techniques are now being applied for T4 lesions due to improvements in surgery and anesthesiology and progress in combined treatment modalities. In the present staging, T4N0–1M0 lesions are categorized as stage IIIA disease, and T4 tumors without mediastinal nodal metastasis are now considered to be potentially curable if complete resection is possible. This article reviews the modern surgical management of patients with lung cancer invading neighboring structures, including the chest wall, superior sulcus, diaphragm, tracheal carina, left atrium, superior vena cava, aorta and vertebrae. Furthermore, the surgical treatment of carcinomatous pleuritis, which was categorized as T4 disease in the previous TNM classification, is also assessed, and the role of surgical resection in cases of locally advanced lung cancer is discussed.
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Metadaten
Titel
Surgical management of locally advanced lung cancer
verfasst von
Kohei Yokoi
Tetsuo Taniguchi
Noriyasu Usami
Koji Kawaguchi
Takayuki Fukui
Futoshi Ishiguro
Publikationsdatum
01.09.2014
Verlag
Springer Japan
Erschienen in
General Thoracic and Cardiovascular Surgery / Ausgabe 9/2014
Print ISSN: 1863-6705
Elektronische ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-014-0425-7

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