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Surgery in lung cancer

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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In general only 20% of all new cases of non-small cell lung cancer ever go to surgery. The overall 5-year survival after surgery is about 25%.

Absolute contraindications for surgery include:

  • patient refusal
  • metastases (CT scanning now detects metastases more frequently than a decade ago)

Relative contraindications include:

  • the cell type - small cell carcinoma are usually inoperable
  • poor respiratory reserve:
    • FEV1 > 1.2l is necessary for lobectomy, and > 1.8l for pneumonectomy
    • a raised PaCO2 is a contraindication for surgery
  • other disease - especially myocardial
  • mediastinal involvement
  • age - in patients over 70, surgery is usually inadvisable because the benefits are outweighed by operative morbidity and mortality

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