The Ability of Surgery in T4 Lung Cancer

Abstract

According to the staging system, T4 cases have been identified as tumors larger than 7cm or invasive tumors on tissues, such as the diaphragm, mediastinum, heart, large vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral body, or separate tumor nodule(s) on a different lobe on the same side. In this manuscript, the srugical treatment of T4 N0-1 lung cancer that made tracheal, carina, vertebra, thoracic inlet, vena cava superior, mediastinal structures and diyafragmatic invasion. Medical literature in the thoracic surgery and oncology network was reviewed, and studies, cases, and meta-analysis studies that included surgical treatment practices in oligometastatic small cell lung cancer treatment and their results were examined. A discussion was made by also analyzing the survival data in light of the literature studies and available guidelines. In recent years, indications of lung cancer surgery have also been expanded in parallel with the advancements in multidisciplinary surgery and in multidisciplinary oncological treatment protocols, and thus surgery has become applicable for more patients. T4 N 0-1 cases are approximately 30 % of all lung cancer cases and despite 5 year survival is about 10 %, there are survival advantages in patients who have complete resection. T4 tumor surgery should be applied in experienced centers and by multidisciplinary surgery teams. Treatment decisions should be individualized, and complete surgery should be considered for NO-1 cases whose activity rate could be high.