Surgical treatment of lung cancer

The role of surgical treatment for lung cancer at different stages is mainly reflected in: removing early localized cancer to achieve the goal of clinical cure; relatively thoroughly removing all cancer tissues and intrathoracic lymph nodes to strive for clinical cure; removing most of the cancer tissue to create favorable conditions for radiotherapy, chemotherapy, immunotherapy and traditional Chinese medicine; alleviating patients' secondary and concurrent symptoms, reducing pain and improving their quality of life.

The standard for measuring the effectiveness of surgical treatment of lung cancer is the 5-year survival rate and quality of life after surgery. At present, the overall 5-year survival rate of lung cancer treatment is about 10%, and it can reach 12%-16% in developed Western countries. After multidisciplinary treatment such as surgery, the survival rate can be increased by 3 times to about 30%-40%.

Indications for surgery in lung cancer

(1) Surgical indications for NSCLC. It is generally believed that stage 1, stage II, and some stage IIIA are candidates for surgical treatment. For extensive N2 and stage IIIB lung cancer, it is advisable to first undergo preoperative induction chemotherapy or radiotherapy before considering surgery. Stage IV is generally not suitable for surgical treatment.

(2) Indications for surgery in SCLC. Patients with clinical stage 1 SCLC who are estimated to be able to undergo radical resection; patients with stage II SCLC who are estimated to be able to undergo radical resection after chemotherapy; patients with stage IIIA SCLC who achieve remission (CR, PR) after chemotherapy, which is considered to be an expanded scope of surgery and is more suitable for mixed SCLC in younger patients; patients with stage IIIA SCLC who do not achieve remission or have no effect after chemotherapy, but whose lesion range is estimated to allow surgery (if the lesion is estimated to be able to remain during surgery, a metal marker should be placed locally to prepare for radiotherapy, followed by chemotherapy).