Surgical Management of Stage IIIA Non-small Cell Lung Cancer

Abstract

There remains equipoise regarding the optimal treatment approach for patients with stage IIIA non-small cell lung cancer (NSCLC). The purpose of this review is to examine the role of surgery as a modality in the management of stage IIIA NSCLC. Over the last two decades, several studies including randomized controlled trials have established the importance of multimodality therapies in the management of locally advanced NSCLC. Significant disparities exist in the reported advantages of surgery between observational and randomized controlled studies of stage IIIA patients. While some of these differences are likely due to patient selection bias, differences in the study design and treatment-related factors may also contribute to these trends. Preliminary results from studies assessing molecular therapies and immunotherapies in this population indicate a favorable adverse event and clinical response profile. As the therapeutic armamentarium for stage IIIA disease expands, continued evaluation of surgery within multimodality treatment protocols will be increasingly important.