Primary Tumours

  • Lawrence Okiror
  • Maninder Singh Kalkat
  • Pala B. Rajesh
Chapter

Abstract

Lung cancer remains the leading cause of cancer deaths worldwide. A reduction in the smoking rates in the developed world has led to declining numbers of patients diagnosed with lung cancer. The role of surgery in the management of lung cancer patients encompasses the whole spectrum of the patient pathway including diagnosis, staging, resection with curative intent, palliation of advanced disease and multimodality treatment of selected patients. Advances in imaging and endoscopic staging techniques have led to better selection of patients likely to benefit from surgical resection. This has also reduced the need for invasive surgical staging. The advent of minimally invasive surgical techniques and a multidisciplinary approach to patient selection and optimization for surgery has led to falling perioperative mortality rates despite surgeons taking on increasingly older patients with multiple comorbidities. Large databases have led to validated risk-stratification models that guide patient selection for surgery. A number of randomised trials have helped clarify the role of surgery in multimodality treatment of lung cancer patients with locally advanced disease.

In spite of these advances, survival and cure rates from lung cancer remain dismally low. Newer strategies including screening of high-risk groups and early referral for imaging of patients with persisting chest symptoms are likely to result in more patients having early detection of their cancers with a potential for curative surgery. Advances in our understanding of tumour biology and the development of effective targeted treatments for patients with advanced disease may improve the prognosis of patients with advanced lung cancer with a potential role of surgery for palliative symptom control and multimodality treatment.

Keywords

Surgery for lung cancer Patient selection 

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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  • Lawrence Okiror
    • 1
  • Maninder Singh Kalkat
    • 1
  • Pala B. Rajesh
    • 1
  1. 1.Regional Department of Thoracic SurgeryBirmingham Heartlands HospitalBirminghamUK

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