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Review
. 2013 Oct;5 Suppl 5(Suppl 5):S593-606.
doi: 10.3978/j.issn.2072-1439.2013.07.39.

Surgery in 2013 and beyond

Rishendran Naidoo  1 , Morgan N Windsor, Peter Goldstraw
Affiliations
Review

Surgery in 2013 and beyond

Rishendran Naidoo et al. J Thorac Dis. 2013 Oct.

Abstract

Lung cancer is a leading cause of cancer related mortality. The role of surgery continues to evolve and in the last ten years there have been a number of significant changes in the surgical management of lung cancer. These changes extend across the entire surgical spectrum of lung cancer management including diagnosis, staging, treatment and pathology. Positron Emission Tomography (PET) scanning and ultrasound (EBUS) have redefined traditional staging paradigms, and surgical techniques, including video-assisted thoracoscopy (VATS), robotic surgery and uniportal surgery, are now accepted as standard of care in many centers. The changing pathology of lung cancer, with more peripheral tumours and an increase in adenocarcinomas has important implications for the Thoracic surgeon. Screening, using Low-Dose CT scanning, is having an impact, with not only a higher percentage of lower stage cancers detected, but also redefining the role of sublobar resection. The incidence of pneumonectomy has reduced as have the rates of "exploratory thoracotomy". In general, lung resection is considered for stage I and II patients with a selected role in more advanced stage disease as part of a multimodality approach. This paper will look at these issues and how they impact on Thoracic Surgical practice in 2013 and beyond.

Keywords: Lung cancer; surgery.

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Figures

Figure 1
Figure 1
Cancer incidence and mortality worldwide. Ferlay J, Shin HR, Bray F, Forman D, Mathers C and Parkin DM. GLOBOCAN 2008 v2.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10. Lyon, France: International Agency for Research on Cancer; 2010. Available from: http://globocan.iarc.fr, accessed on 14/05/2013.
Figure 2
Figure 2
Incidence and mortality of lung cancer in men and women.
Figure 3
Figure 3
Trends in incidence of lung cancer in men.
Figure 4
Figure 4
Trends in incidence of lung cancer in women.
See this image and copyright information in PMC

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