Large cell carcinoma of the lung surgery: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Large cell carcinoma of the lung}} | {{Large cell carcinoma of the lung}} | ||
{{CMG}}; {{AE}} {{ | {{CMG}}; {{AE}} {{MV}} | ||
==Overview== | ==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]], [[mechanical ventilation|prolonged mechanical ventilation]], [[respiratory failure]], [[bronchospasm]], [[pulmonary embolism]]. | 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]], [[mechanical ventilation|prolonged mechanical ventilation]], [[respiratory failure]], [[bronchospasm]], [[pulmonary embolism]]. | ||
==Surgery== | ==Surgery== | ||
*Surgery is the mainstay of treatment for large cell carcinoma of the lung | *Surgery is the mainstay of treatment for large cell carcinoma of the lung.<ref name="pmid15063228">{{cite journal |vauthors=Doddoli C, Barlesi F, Chetaille B, Garbe L, Thomas P, Giudicelli R, Fuentes P |title=Large cell neuroendocrine carcinoma of the lung: an aggressive disease potentially treatable with surgery |journal=Ann. Thorac. Surg. |volume=77 |issue=4 |pages=1168–72 |date=April 2004 |pmid=15063228 |doi=10.1016/j.athoracsur.2003.09.049 |url=}}</ref><ref name="pmid16618956">{{cite journal |vauthors=Smetana GW, Lawrence VA, Cornell JE |title=Preoperative pulmonary risk stratification for noncardiothoracic surgery: systematic review for the American College of Physicians |journal=Ann. Intern. Med. |volume=144 |issue=8 |pages=581–95 |year=2006 |pmid=16618956 |doi= |url=}}</ref><ref name="pmid9458138">{{cite journal |vauthors=Wertzel H, Grahmann PR, Bansbach S, Lange W, Hasse J, Böhm N |title=Results after surgery in undifferentiated large cell carcinoma of the lung: the role of neuroendocrine expression |journal=Eur J Cardiothorac Surg |volume=12 |issue=5 |pages=698–702 |date=November 1997 |pmid=9458138 |doi= |url=}}</ref> | ||
*Common surgical procedures for the treatment of large cell carcinoma of the lung, include: | *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: <ref name="wiki">Lung cancer surgery. Wikipedia. https://en.wikipedia.org/wiki/Lung_cancer_surgery Accessed on March 10, 2016</ref> | |||
:*[[Lobectomy|Pulmonary lobectomy]] | :*[[Lobectomy|Pulmonary lobectomy]] | ||
:*[[Pneumonectomy]] | :*[[Pneumonectomy]] | ||
:*Lung resection with lobectomy | :*Lung resection with [[lobectomy]] | ||
:*Lung resection with pneumonectomy with or without lymph node dissection | :*Lung resection with [[pneumonectomy]] with or without lymph node dissection | ||
===Indications=== | |||
Surgery is usually reserved for patients with large cell carcinoma with the following characteristics:<ref name="pmid22054885">{{cite journal |vauthors=von Groote-Bidlingmaier F, Koegelenberg CF, Bolliger CT |title=Functional evaluation before lung resection |journal=Clin. Chest Med. |volume=32 |issue=4 |pages=773–82 |year=2011 |pmid=22054885 |doi=10.1016/j.ccm.2011.08.001 |url=}}</ref> | |||
*Pulmonary function testing: | |||
==Indications== | |||
*Pulmonary function testing | |||
:*Preoperative assessment of FEV1/DLCO | :*Preoperative assessment of FEV1/DLCO | ||
:*[[FEV1]] >2 L (or more than 80%) | :*[[FEV1]] >2 L (or more than 80%) | ||
:*[[DLCO]] > 80 | :*[[DLCO]] > 80 | ||
*Exercise testing | *Exercise testing: | ||
:*Successful cutoff of 22 m on the stair climbing test | :*Successful cutoff of 22 m on the stair climbing test | ||
*Fitness for surgery | *Fitness for surgery: | ||
:*Evaluation of risk factors, such as: | :*Evaluation of risk factors, such as: | ||
:*Age | :*Age | ||
| Line 31: | Line 32: | ||
:*[[Chronic obstructive pulmonary disease]] | :*[[Chronic obstructive pulmonary disease]] | ||
:*[[Asthma]] | :*[[Asthma]] | ||
:*Smoking | :*[[Smoking]] | ||
:*Other conditions: [[pulmonary hypertension]], [[heart failure]], and metabolic factors | :*Other conditions: [[pulmonary hypertension]], [[heart failure]], and metabolic factors | ||
==Contraindications== | ===Contraindications=== | ||
Large cell carcinoma of the lung surgery is usually contraindicated in patients with the following characteristics: | 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 | Large cell carcinoma of the lung extension past the diaphragm: | ||
:*Extrathoracic metastases | :*Extrathoracic [[metastases]]. | ||
:*Metastases to supraclavicular lymph nodes | :*Metastases to supraclavicular lymph nodes. | ||
:*Contralateral mediastinal node metastases | :*Contralateral mediastinal node metastases. | ||
*Involvement of contralateral hemithorax | *Involvement of contralateral hemithorax. | ||
*Invasion to structures of the mediastinum | *Invasion to structures of the [[mediastinum]]. | ||
:*Involvement of the main pulmonary artery | :*Involvement of the main [[pulmonary artery]]. | ||
*No fitness for surgery | *No fitness for surgery. | ||
*[[Hypercapnia]] (arterial PCO2 greater than 45 mmHg) | *[[Hypercapnia]] (arterial PCO2 greater than 45 mmHg). | ||
*Inadequate exercise testing results (22 m on the stair climbing test) | *Inadequate exercise testing results (22 m on the stair climbing test). | ||
*Presence of oncological emergency | *Presence of oncological emergency such as [[superior vena cava syndrome]], [[Pleural effusion|malignant pleural effusion]], [[cardiac tamponade]], [[vocal cord]] or [[phrenic nerve paralysis]]. | ||
==Complications== | ===Complications=== | ||
Common complications of large cell carcinoma of the lung surgery, include:<ref name="pmid16618956">{{cite journal |vauthors=Smetana GW, Lawrence VA, Cornell JE |title=Preoperative pulmonary risk stratification for noncardiothoracic surgery: systematic review for the American College of Physicians |journal=Ann. Intern. Med. |volume=144 |issue=8 |pages=581–95 |year=2006 |pmid=16618956 |doi= |url=}}</ref> | Common complications of large cell carcinoma of the lung surgery, include:<ref name="pmid16618956">{{cite journal |vauthors=Smetana GW, Lawrence VA, Cornell JE |title=Preoperative pulmonary risk stratification for noncardiothoracic surgery: systematic review for the American College of Physicians |journal=Ann. Intern. Med. |volume=144 |issue=8 |pages=581–95 |year=2006 |pmid=16618956 |doi= |url=}}</ref> | ||
*[[Atelectasis]] | *[[Atelectasis]] | ||
*Infections | *[[Infections]] | ||
:*[[Nosocomial pneumonia]] | :*[[Nosocomial pneumonia]] | ||
*[[Mechanical ventilation|Prolonged mechanical ventilation]] | *[[Mechanical ventilation|Prolonged mechanical ventilation]] | ||
| Line 70: | Line 71: | ||
[[Category:Lung cancer]] | [[Category:Lung cancer]] | ||
[[Category:Oncology]] | [[Category:Oncology]] | ||
[[Category:Up-To-Date]] | |||
[[Category:Oncology]] | |||
[[Category:Medicine]] | |||
[[Category:Pulmonology]] | |||
[[Category:Surgery]] | |||
Latest revision as of 21:03, 3 March 2018
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Large Cell Carcinoma of the Lung Microchapters |
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Differentiating Large Cell Carcinoma of the Lung from other Diseases |
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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]
- Pulmonary lobectomy
- Pneumonectomy
- Lung resection with lobectomy
- Lung resection with pneumonectomy with or without lymph node dissection
Indications
Surgery is usually reserved for patients with large cell carcinoma with the following characteristics:[5]
- Pulmonary function testing:
- Exercise testing:
- Successful cutoff of 22 m on the stair climbing test
- Fitness for surgery:
- Evaluation of risk factors, such as:
- Age
- General health status (obesity, Karnofsky scale >70)
- Chronic obstructive pulmonary disease
- Asthma
- Smoking
- Other conditions: pulmonary hypertension, heart failure, and metabolic factors
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.
- Involvement of the main pulmonary artery.
- No fitness for surgery.
- Hypercapnia (arterial PCO2 greater than 45 mmHg).
- Inadequate exercise testing results (22 m on the stair climbing test).
- Presence of oncological emergency such as superior vena cava syndrome, malignant pleural effusion, cardiac tamponade, vocal cord or phrenic nerve paralysis.
Complications
Common complications of large cell carcinoma of the lung surgery, include:[2]
References
- ↑ 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. doi:10.1016/j.athoracsur.2003.09.049. PMID 15063228.
- ↑ 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.
- ↑ 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.
- ↑ Lung cancer surgery. Wikipedia. https://en.wikipedia.org/wiki/Lung_cancer_surgery Accessed on March 10, 2016
- ↑ von Groote-Bidlingmaier F, Koegelenberg CF, Bolliger CT (2011). "Functional evaluation before lung resection". Clin. Chest Med. 32 (4): 773–82. doi:10.1016/j.ccm.2011.08.001. PMID 22054885.