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Management of Unexpected N2 Disease Discovered at Thoracotomy

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Difficult Decisions in Thoracic Surgery

Abstract

The appropriate therapy for stage IIIa (N2) non-small cell lung cancer (NSCLC) is not clearly established. Recent randomized trials demonstrate that preoperative chemoradiotherapy followed b y resection improves long-term and disease-free survival compared with surgery alone. These results have bolstered the interest in multimodality treatment for patients with resectable N2 disease. Furthermore, the literature suggests that neoadjuvant therapy followed by surgery is superior to resection and subsequent adjuvant treatment, although such a comparison has not been definitively studied. Based on these results, patients who a re found to have N2 nodal metastasis prior to thoracotomy, using methods such as mediastinoscopy, thoracoscopy, endoscopic ultrasonography, transbronchial needle aspiration, or possibly positron emission tomography (PET) scanning, should receive neoadjuvant treatment prior to resection.

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Authors and Affiliations

  1. Department of Surgery, The University of Chicago, Chicago, IL, USA

    Hyde M. Russell MD & Mark K. Ferguson MD

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  1. Hyde M. Russell MD
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  2. Mark K. Ferguson MD
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Editors and Affiliations

  1. Department of Surgery, The University of Chicago, Chicago, IL, USA

    Mark K. Ferguson MD (Professor and Head) (Professor and Head)

  2. Thoracic Surgery Service, The University of Chicago Hospitals, Chicago, IL, USA

    Mark K. Ferguson MD (Professor and Head) (Professor and Head)

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© 2007 Springer-Verlag London Limited

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Russell, H.M., Ferguson, M.K. (2007). Management of Unexpected N2 Disease Discovered at Thoracotomy. In: Ferguson, M.K. (eds) Difficult Decisions in Thoracic Surgery. Springer, London. https://doi.org/10.1007/978-1-84628-474-8_8

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  • DOI: https://doi.org/10.1007/978-1-84628-474-8_8

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84628-384-0

  • Online ISBN: 978-1-84628-474-8

  • eBook Packages: MedicineMedicine (R0)

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