Surgery in Non–Small-Cell Lung Cancer

Surgical management of the patient with non–small-cell lung cancer (NSCLC) is complex. When should stereotactic body radiation therapy be used? What are the advantages of video-assisted thoracic surgery? Test your knowledge in our latest quiz.

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This practice pattern was selected by 90.5% of the member institutions, according to the NCCN. In addition, 80% said they would use endobronchial ultrasound with or without endoscopic ultrasound in initial evaluation of the mediastinum, and 40.5% noted they would use pathologic evaluation of the mediastinum, after neoadjuvant therapy, to make a final decision before surgery.

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The guidelines note that such patients should be counseled about the subsequent risk of locoregional and distant failure.

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The study found that half of patients alive at 5 years were alive at 10 years, with 10-year survival “associated with younger age, earlier stage, non-squamous histology, lobectomy, and fewer comorbidities, but not race.”

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The study compared overall survival and lung cancer–specific survival among patients after lobectomy, segmentectomy, or wedge resection.

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VATS is also associated with a shorter length of hospitalization, minimal locoregional recurrence, and improved discharge independence in older and high-risk patients, according to the guidelines.