From the Division of General Thoracic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
Cancer J. 2011 Jan-Feb;17(1):11-7. doi: 10.1097/PPO.0b013e31820a0b2d.
Optimal management of non-small cell lung cancer requires treatment approach to be tailored to both the particular disease stage and the overall health and functional status of the patient. Even though surgical resection by means of an anatomic lobectomy remains the treatment of choice with the goal of cure for early-stage lung cancer, it is an invasive procedure with associated morbidity and mortality. Although these risks continue to decrease in the modern era with improvements in surgical technique and perioperative management, the risks are elevated in patients with associated medical comorbidities. As a consequence, patients at potentially increased or high risk for surgical lobectomy need to be identified by a structured preoperative assessment. This has gained increasing importance, given the emergence of alternative treatment approaches such as minimally invasive surgery, less extensive pulmonary resection, and stereotactic body radiation therapy. We review the clinical approach to suspected early-stage lung cancer based on a tumor and patient-centered stratification of risk and benefit.
非小细胞肺癌的最佳治疗管理需要根据特定的疾病阶段以及患者的整体健康和功能状态来调整治疗方法。尽管通过解剖性肺叶切除术进行手术切除仍然是早期肺癌治疗的首选方法，旨在实现治愈，但这是一种具有相关发病率和死亡率的侵袭性手术。尽管随着手术技术和围手术期管理的改进，这些风险在现代不断降低，但在存在相关合并症的患者中，风险会升高。因此，需要通过结构化的术前评估来识别有潜在手术肺叶切除术增加或高风险的患者。鉴于替代治疗方法的出现，如微创手术、较少的肺部分切除术和立体定向体放射治疗，这种评估方法的重要性日益增加。我们根据肿瘤和患者为中心的风险和获益分层，综述疑似早期肺癌的临床处理方法。
