Is Surgery Still the Best Option for Early Stage NSCLC?
Under the formidable thrust of alternative management options for early stage lung cancer, the role of surgery in this disease subset has been questioned. Stereotactic body radiotherapy (SBRT) has been advocated as an ideal substitute for surgery not only in high risk patients or for the ones who refuse surgery but also in lieu of sublobar resection in otherwise fit patients. The therapeutic modalities for early stage NSCLC were compared as to warranting local control, enabling adequate tissue sampling for biomolecular studies, and effecting optimal pathologic staging while saving lung parenchyma. As a result, surgery still remains the best management option for early stage lung cancer in 2014.
Nowadays, modern clinical outcomes and cost-effectiveness issues mandate careful attention to the process flow governing the diagnostic and therapeutic pathways in lung cancer management. Best practice protocols, like Proven Care, are characterized by the focus on the diagnostic and therapeutic value of surgery as the central modality in managing early as well as locally advanced NSCLC. Indeed, surgery has been considered for decades the ideal therapeutic option mainly to ensure optimal local control of the disease. The aim of this paper is to demonstrate that minimally invasive thoracic surgery (MITS) remains the best management choice for early NSCLC because, besides continuing to warrant best local control, it is crucial to provide tissue for biomolecular studies and effect the best pathological staging while preserving lung parenchyma.
Abstract and Introduction
Abstract
Under the formidable thrust of alternative management options for early stage lung cancer, the role of surgery in this disease subset has been questioned. Stereotactic body radiotherapy (SBRT) has been advocated as an ideal substitute for surgery not only in high risk patients or for the ones who refuse surgery but also in lieu of sublobar resection in otherwise fit patients. The therapeutic modalities for early stage NSCLC were compared as to warranting local control, enabling adequate tissue sampling for biomolecular studies, and effecting optimal pathologic staging while saving lung parenchyma. As a result, surgery still remains the best management option for early stage lung cancer in 2014.
Introduction
Nowadays, modern clinical outcomes and cost-effectiveness issues mandate careful attention to the process flow governing the diagnostic and therapeutic pathways in lung cancer management. Best practice protocols, like Proven Care, are characterized by the focus on the diagnostic and therapeutic value of surgery as the central modality in managing early as well as locally advanced NSCLC. Indeed, surgery has been considered for decades the ideal therapeutic option mainly to ensure optimal local control of the disease. The aim of this paper is to demonstrate that minimally invasive thoracic surgery (MITS) remains the best management choice for early NSCLC because, besides continuing to warrant best local control, it is crucial to provide tissue for biomolecular studies and effect the best pathological staging while preserving lung parenchyma.