Large cell carcinoma of the lung surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Surgery is the mainstay of treatment for large cell carcinoma of the lung. Common surgical procedures for the treatment of large cell carcinoma of the lung, include: pulmonary lobectomy, pneumonectomy, lung resection with lobectomy, lung resection with pneumonectomy with or without lymph node dissection. The preferred surgical procedure is thoracotomy with removal of the entire lung or lobe (lobectomy) along with regional lymph nodes and contiguous structures. Common complications of squamous cell carcinoma of the lung surgery, include: atelectasis, nosocomial pneumonia, prolonged mechanical ventilation, respiratory failure, bronchospasm, pulmonary embolism.

Surgery

  • Surgery is the mainstay of treatment for large cell carcinoma of the lung.[1][2][3]
  • The feasibility of surgery depends on the stage of squamous cell carcinoma of the lung at diagnosis.
  • Surgical intervention is not recommended for the management of metastatic squamous cell carcinoma of the lung.

Surgical Options

  • Common surgical procedures for the treatment of large cell carcinoma of the lung, include: [4]

Indications

Surgery is usually reserved for patients with large cell carcinoma with the following characteristics:[5]

  • Pulmonary function testing:
  • Preoperative assessment of FEV1/DLCO
  • FEV1 >2 L (or more than 80%)
  • DLCO > 80
  • Exercise testing:
  • Successful cutoff of 22 m on the stair climbing test
  • Fitness for surgery:

Contraindications

Large cell carcinoma of the lung surgery is usually contraindicated in patients with the following characteristics: Large cell carcinoma of the lung extension past the diaphragm:

  • Extrathoracic metastases.
  • Metastases to supraclavicular lymph nodes.
  • Contralateral mediastinal node metastases.
  • Involvement of contralateral hemithorax.
  • Invasion to structures of the mediastinum.

Complications

Common complications of large cell carcinoma of the lung surgery, include:[2]

References

  1. Doddoli C, Barlesi F, Chetaille B, Garbe L, Thomas P, Giudicelli R, Fuentes P (April 2004). "Large cell neuroendocrine carcinoma of the lung: an aggressive disease potentially treatable with surgery". Ann. Thorac. Surg. 77 (4): 1168–72. PMID 15063228. doi:10.1016/j.athoracsur.2003.09.049. 
  2. 2.0 2.1 Smetana GW, Lawrence VA, Cornell JE (2006). "Preoperative pulmonary risk stratification for noncardiothoracic surgery: systematic review for the American College of Physicians". Ann. Intern. Med. 144 (8): 581–95. PMID 16618956. 
  3. Wertzel H, Grahmann PR, Bansbach S, Lange W, Hasse J, Böhm N (November 1997). "Results after surgery in undifferentiated large cell carcinoma of the lung: the role of neuroendocrine expression". Eur J Cardiothorac Surg. 12 (5): 698–702. PMID 9458138. 
  4. Lung cancer surgery. Wikipedia. https://en.wikipedia.org/wiki/Lung_cancer_surgery Accessed on March 10, 2016
  5. von Groote-Bidlingmaier F, Koegelenberg CF, Bolliger CT (2011). "Functional evaluation before lung resection". Clin. Chest Med. 32 (4): 773–82. PMID 22054885. doi:10.1016/j.ccm.2011.08.001. 

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