Four indications for surgical treatment of lung cancer

Surgical treatment of lung cancer should follow the principle of "two maximums", that is, to remove tumor lesions, metastatic lymph nodes and invaded adjacent tissues to the maximum extent, and to preserve normal lung tissue to the maximum extent. However, since 70% to 75% of lung cancer patients are no longer in the early stage or do not meet the ideal conditions for surgical resection when they seek medical treatment, it is very important to strictly control the indications for surgery in order to improve the 5-year survival rate and quality of life after surgery. The indications for surgery are:

① Patients with primary lung cancer confirmed by cytology or histology in stage I and II lung cancer, as well as some stage III cases, whose general condition can tolerate surgery.

② The primary lesion of metastatic lung cancer has been cured for more than one year, and a single lesion in the lung has been systematically examined to show no local recurrence of the primary tumor and no metastasis to other organs.

③ Solitary spherical lesions in the lungs. The lesions are located in common tumor sites such as the anterior segment of the upper lobe. The diagnosis cannot be confirmed by sputum exfoliative cytology, fiberoptic bronchoscopy or percutaneous lung biopsy. Characteristic manifestations of lung cancer are seen in the layered films or CT, such as lobulation, spiculation, cavitation, etc. The patient is highly suspected of lung cancer and has high risk factors for lung cancer. Thoracotomy and frozen sectioning should be considered, and the surgical plan should be decided based on the results.

④ Lobar or segmental pneumonia or atelectasis should be examined by fiberoptic bronchoscopy first. More than 90% of central lung cancers can obtain positive cytological or histological results. However, this type of lung cancer sometimes only manifests as submucosal infiltration of the bronchial mucosa, and the positive diagnosis rate of histology and cytology is low. Whether to perform thoracotomy should be determined based on clinical conditions.