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Non-small Cell Lung Cancer^*

Role of Surgery for Stages I-III

^* From Toronto General Hospital, Toronto, Ontario, Canada.

Correspondence to: F. Griffith Pearson, MD, Toronto General Hospital, Eaton North 10–233, 200 Elizabeth St, Toronto, Ontario, Canada M5G-2C4; e-mail: pearson{at}user.rose.com

Survival following surgical resection of non-small cell lung cancer (NSCLC) has improved since the 1960s, although the 5-year survival rate remains low. This article provides an overview of the role of surgery for NSCLC stages I-III, with a focus on optimizing long-term survival in those patients with resectable disease. Topics explored include diagnosis and staging, indications for resection, types of resection, and indications for adjuvant therapy. A review of the literature indicates a clear survival advantage for complete resection, and is suggestive of an advantage for mediastinal lymph node dissection (vs lymph node sampling) and neoadjuvant therapy (vs adjuvant therapy).

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