Patané Ana Karina
Department of Thoracic Surgery, Hospital de Rehabilitación Respiratoria María Ferrer, Buenos Aires, Argentina.
Transl Lung Cancer Res. 2021 Jan;10(1):519-528. doi: 10.21037/tlcr.2020.03.27.
Locally advanced lung cancer, defined by nodal involvement in upper mediastinal stations (N2) (stage IIIA-N2), includes a wide spectrum of patients with multiple therapeutic alternatives. Such heterogeneity is explained, at least in part, by tumor size and magnitude of mediastinal nodal involvement. In this setting, many variants can influence the prognosis, such as the specific nodal stations compromised, the burden of mediastinal disease, and the presence of skip metastasis. In the surgical field, the advent of minimally invasive techniques, including video-assisted thoracoscopic and robotic surgery, have revolutionized the management of early-stage lung cancer, but implementations of these approaches in the locally advanced setting have been erratic. This review attempts to highlight the most relevant scientific data of the surgical management of locally advanced lung cancer patients, analyzing not only the medical evidence but also the cost-effectiveness and accessibility.
局部晚期肺癌定义为上纵隔淋巴结受累（N2）（IIIA-N2期），涵盖了众多具有多种治疗选择的患者。这种异质性至少部分可由肿瘤大小和纵隔淋巴结受累程度来解释。在这种情况下，许多变量会影响预后，例如受累的特定淋巴结站、纵隔疾病负担以及跳跃转移的存在。在外科领域，包括电视辅助胸腔镜手术和机器人手术在内的微创技术的出现，彻底改变了早期肺癌的治疗方式，但这些方法在局部晚期情况下的应用并不稳定。本综述试图突出局部晚期肺癌患者外科治疗的最相关科学数据，不仅分析医学证据，还分析成本效益和可及性。
