Place de la chirurgie

Non-small cell lung cancer (NSCLC) of early stage (stage I and II) form a wide variety of numerous heterogeneous tumors in respect to the T, the N and the histology. However, they share the common characteristic of being resectable, so providing the best chances of cure in patients amenable to surgery. A wide range of resections is available and the tendency at the present time is to favour resections permitting to avoid performing pneumonectomy, an operation whose postoperative mortality may be considerable, particularily on the right side. The place of surgery is of paramount importance in view of cure on condition that the resection is complete, that is without any tumor left behind, and includes a radical mediastinal lymphadenectomy. The place of surgery is also often diagnostic as well as therapeutic, and surgery provides the best histologic classification, the most accurate staging, and thus the best adapted adjuvant therapy and global management.