Squamous 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 squamous cell carcinoma of the lung. Common surgical procedures for the treatment of squamous 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 squamous cell carcinoma of the lung[1]
- Common surgical procedures for the treatment of squamous cell carcinoma of the lung, include:
- Pulmonary lobectomy
- Pneumonectomy
- Lung resection with lobectomy
- Lung resection with pneumonectomy with or without lymph node dissection
- 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
Indications
Squamous cell carcinoma of the lung is usually reserved for patients with the following characteristics:[2]
- 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
Squamous cell carcinoma of the lung surgery is usually contraindicated in patients with the following characteristics:
- Squamous 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 squamous cell carcinoma of the lung surgery, include:[1]
- Atelectasis
- Infections
References
- ↑ 1.0 1.1 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.
- ↑ 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.