According to an article recently published in the journal Thorax, the surgical removal of lung cancer (surgical resection) produces favorable survival rates among patients with lung cancer, even those with advanced stages of lung cancer.

Lung cancer is the leading cause of cancer-related deaths in the world. In the United States, lung cancer claims more lives every year than colon cancer, prostate cancer, and breast cancer combined.

Treatment for lung cancer is largely based on the stage, or extent of spread of the lung cancer. In addition, the overall health of the patient is considered when choosing appropriate treatments. Surgical resection of lung cancer is typically reserved for patients with the earliest stages of disease. Patients with more advanced lung cancer tend to be treated with the following therapies alone or in various combinations: chemotherapy, radiation therapy, and targeted therapy.

The following is an overview of stages of lung cancer:

  • Stage I lung cancer refers to cancer that has not spread from its site of origin.
  • Stage II lung cancer refers to cancer that is located in one lung and may involve lymph nodes on the same side of the chest. It does not include lymph nodes in the space between the lungs (the mediastinum) or outside the chest.
  • Stage IIIA lung cancer refers to cancer that is a single tumor or mass that is not invading any adjacent organs. It involves one or more lymph nodes away from the tumor, but not outside the chest.
  • Stage IIIB lung cancer refers to cancer that has spread to more than one area in the chest, but not outside the chest.
  • Stage IV lung cancer refers to cancer that has spread to distant sites in the body.

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Researchers from Norway recently analyzed data to evaluate the effectiveness of surgical resection in patients with lung cancer. This study included data from 3,211 patients who were diagnosed with lung cancer and underwent surgical resection for their disease between 1993 and 1999. The researchers evaluated survival rates for these patients since data regarding long-term survival for this group of patients is limited.

  • At five years, patients diagnosed with Stage I lung cancer had a survival rate of 58.4%; those diagnosed with Stage II had a survival rate of 28.4%; those diagnosied with Stage IIIA had a survival rate of 15.1%; those diagnosed with Stage IIIB had a survival rate of 24.1%; those diagnosed with Stage IV had a survival rate of 21.1%.
  • Patients with the following characteristics tended to have a worse survival than others: male gender, more advanced age, surgical procedure performed other than an upper or middle lobectomy (removal of a lobe of the lung), types of cancers besides adenocarcinoma and large cell carcinoma (refers to the type of cell within the lung where the cancer originated), surgery on the right side of the body, cancer cells found on the margins on the surgically removed cancer specimen, and a large cancer size.

The researchers concluded that, when compared to standard therapies, it appears that survival at five years is quite favorable among patients who undergo surgical resection of lung cancer, even among those with advanced stages of the disease. The authors state that “These results question the validity of the current TNM system for lung cancer with regard to tumour size and categorization of multiple tumours.” This means that the results question the standard procedures used to determine therapeutic approaches for patients with this disease.

Patients with lung cancer may wish to speak with their physician regarding their individual risks and benefits of surgical resection.

Reference: Strand T-E, Rostad H, Moller B, Norstein J. Survival After Resection of Primary Lung Cancer: a Population Based Study of 3211 Resected Patients. Thorax. 2006; 61:710-715.

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