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(Chest. 1999;116:477S-479S.)
© 1999 American College of Chest Physicians

Treatment of Patients With Lung Cancer and Severe Emphysema*

Steven J. Mentzer, MD, FCCP and Scott J. Swanson, MD, FCCP

* From the Division of Thoracic Surgery, Department of Surgery, Brigham and Women’s Hospital, and the Dana-Farber Cancer Institute, Harvard Medical School Boston, MA.

Correspondence to: Steven J. Mentzer, MD, FCCP, Division of Thoracic Surgery, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115; e-mail: sjmentzer{at}bics.bwh.harvard.edu

The development of lung cancer and emphysema is associated with the destructive chemical milieu that occurs with smoking. The recent interest in lung volume reduction surgery (LVRS) has stimulated a reassessment of the indications for surgery in patients with early stage lung cancer or emphysema. For patients with both diseases, the issues surrounding LVRS are simplified. The major concern is that the lung cancer can be surgically removed without the need for postoperative ventilation or mortality. A secondary consideration is the potential for long-term postoperative respiratory morbidity. These risks can be estimated by evaluating the anatomic location of the tumor, as well as the physiology of the underlying emphysema. Early results of combined LVRS and lung cancer resections suggest a favorable outcome in carefully selected patients.




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