Abstract
Surgery remains the only curative modality for early stage of Non small cell lung caner (NSCLC). We reviewed overall scenario of lung cancer and surgical results in Nepal. 1000 patients with the pathological diagnosis of lung cancer were analyzed to summarize the overall scenario of lung cancer. 157 NSCLC patients underwent pulmonary resection. cIA, IB, IIA, IIB, IIIA (N1) underwent surgery as initial modality of treatment. cIIIA (N2) patients were taken for surgery after neoadjuvant chemo/ chemoradiation. Analysis of 1000 patients showed squamous cell carcinoma in 41.3%, incurable stage (IIIB/ IV) in 66.8% and rate of curative resection in 6.7% cases. Surgery as a single modality of treatment was used in 38%. Neoadjuvant Chemo/ chemoradiation/ radiation followed by surgery and surgery followed by chemo/ chemoradiation/ radiation was done in 12% and 50%, respectively. In-hospital mortality was 2% (post pneumonectomy: 5.5%; post lobectomy: 1.5%; post sublobar resection: 0%). R0 resction was achieved in 91% cases. Median survival and 5-year overall survival were 36 months and 18%, respectively. Better survival was achieved in pI-II vs pIII/ IV, pN0-1 vs pN2 and pR0 vs pR+ (p <0.05). Earlier stage (pI-II), R0 resection and pathological pNo-1 has the best five year overall survival in Nepalese patients with NSCLC as well.
Highlights
Surgery remains the only curative modality for early stage of Non small cell lung caner (NSCLC)
We reviewed overall scenario of lung cancer and surgical results in Nepal
157 NSCLC patients underwent pulmonary resection. cIA, IB, IIA, IIB, IIIA (N1) underwent surgery as initial modality of treatment. cIIIA (N2) patients were taken for surgery after neoadjuvant chemo/ chemoradiation
Summary
Surgery remains the only curative modality for early stage of Non small cell lung caner (NSCLC). We reviewed overall scenario of lung cancer and surgical results in Nepal. Lung cancer is the most common cause of cancer death both in male and female. More than 1.35 million people die of lung cancer annually worldwide.. Lung cancer is often diagnosed in advanced stage in older individuals who often harbor additional comorbidities, rendering most patients unresectable and incurable. 85% of lung cancers are Nonsmall cell lung cancer (NSCLC) and surgery remains the only curative modality of treatment. Improving the survival of NSCLC patients is a major challenge for modern multimodality oncological treatment strategies, considering that the 5-year survival remains less than 15% across all stages of disease with fewer than 7% of patients alive 10 years after diagnosis.
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