Dr. Eric Vallieres, thoracic surgeon, discusses the potential to do smaller lung surgeries on patients with a lung cancer that poses a minimal risk of recurrence.

There are multiple different types of lung cancer surgery. Dr. Eric Vallières, thoracic surgeon, reviews the different forms of lung surgery, include wedge resection, segmentectomy, lobectomy, and pneumonectomy.

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Transcript

There is a principle in management of lung cancer that some patients who have a very limited degree of metastatic disease or progression after a good response may do unusually well with local treatment, such as radiation or surgery, for the isolated area(s) of disease that are metastatic or growing.

For early stage NSCLC, the historic standard of care is a lobectomy.  But the reality is that with the median age of patients with new lung cancer a little over 70 and many patients quite sick from their lung cancer, COPD, and/or other medical problems, not every patient is a great candidate for surgery.

The second part of the webinar by Dr.

While post-operative chemotherapy for early stage NSCLC is a well-established standard for relatively healthy patients with stage II or higher resected cancers, the question of whether adjuvant chemotherapy is more likely to help or hurt a patient remains more a matter of debate.

With the median age of patients now being diagnosed with lung cancer in the US a little over 70, the question of how best to manage elderly patients with lung cancer is a very relevant but also understudied question.

This is the first part of a case presentation I did with two great colleagues: Dr. Anne Tsao, who is a medical oncologist and lung cancer expert at MD Anderson Cancer Center in Houston, and Dr. Alex Farivar, who is a terrific thoracic surgeon at my own institution, Swedish Cancer Institute in Seattle.

The subject of stereotactic lung radiotherapy (SBRT) for cure of stage I disease has been extensively covered on GRACE with good cause: we may be witnessing a major change in how we treat early stage cancer. Multiple strategies for improved surveillance are being developed, and hopefully one or more will be successful, resulting in more frequent detection of early stage disease. If so, we will have what my mentor calls a “delicious dilemma” – what is the best way to cure these early-stage patients?

Surgery is the standard treatment for early stage lung cancer, sometimes also including other types of threrapy in addition. There are many types of lung cancer surgery, and there is still active debate about whether a pneumonectomy or lobectomy should be the preferred surgery for lung cancer, or whether a sub-lobar resection, either a segmentectomy or a wedge resection, is appropriate for certain patients. We need to start with some definitions.