606 Resection: Are there limitations?

Abstract

For non small cell lung cancer surgery is the only treatment with a real perspective of long term survival. Especially patients with stage I and stage II benefit from this approach. Whether additional therapy might be beneficial as well is currently under investigation. In daily clinical practice a number of patients present with roentgenologically occult stage I tumours. For these patients endobronchial therapy can also lead to cure. Indications and limitations of this approach will be discussed. With the improvement of diagnostic techniques the detection of small pulmonary nodules has been improved as well in patients with operable non-small cell lung cancer one often has to face the problem of an additional solitary pulmonary nodule: is this a benign or malignant lesion, is it a second primary or a metastasis? In these patients diagnostic and therapeutic thora-coscopy prevents in a number of cases open-and-close thoracotomies and facilitates post-operative recovery prior to the resection of the pathologically proven primary. Another therapeutic problem is the detection of a synchronous single brain metastasis in a patient with an otherwise re-sectable primary lung tumour. Results of resection of synchronous or metachronous M1 disease will be discussed. Or if this occurs in the lung what are the problems of differentiating M1 and a second primary and possibilities of resections after an earlier thoracotomy ? For non small cell lung cancer surgery is the only treatment with a real perspective of long term survival. Especially patients with stage I and stage II benefit from this approach. Whether additional therapy might be beneficial as well is currently under investigation. In daily clinical practice a number of patients present with roentgenologically occult stage I tumours. For these patients endobronchial therapy can also lead to cure. Indications and limitations of this approach will be discussed. With the improvement of diagnostic techniques the detection of small pulmonary nodules has been improved as well in patients with operable non-small cell lung cancer one often has to face the problem of an additional solitary pulmonary nodule: is this a benign or malignant lesion, is it a second primary or a metastasis? In these patients diagnostic and therapeutic thora-coscopy prevents in a number of cases open-and-close thoracotomies and facilitates post-operative recovery prior to the resection of the pathologically proven primary. Another therapeutic problem is the detection of a synchronous single brain metastasis in a patient with an otherwise re-sectable primary lung tumour. Results of resection of synchronous or metachronous M1 disease will be discussed. Or if this occurs in the lung what are the problems of differentiating M1 and a second primary and possibilities of resections after an earlier thoracotomy ?