Fast Five Quiz: Non–Small Cell Lung Cancer Management

Daniel S. Schwartz, MD, MBA

Disclosures

February 03, 2021

Sublobar resections may be used for patients with poor pulmonary reserve. They are increasingly being used in conjunction with video-assisted thoracoscopic surgery.

Surgery is the treatment of choice for patients with stages I-IIIA NSCLC. Patients with stage IIIB and IV NSCLC are usually offered chemotherapy with the option of surgery. Molecular-targeted therapy is becoming increasingly important in the management of advanced NSCLC.

Patients with an FEV1 < 1 L are not considered candidates for surgery. In general, most patients with a preoperative FEV1 > 2.5 L are able to tolerate pneumonectomy; for patients with an FEV1 of 1.1-2.4 L, lobectomy may be possible. The presence of cardiac disease or other comorbidities may also influence a patient's fitness for surgery.

Lobectomy remains the preferred surgical approach for NSCLC because it helps maintain pulmonary function while permitting a good resection. More extensive surgery, such as pneumonectomy, may be required for hilar and other proximal tumors.

Learn more about the surgical management of NSCLC.

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