LUNG-CANCER SURGERY - A CRITICAL-REVIEW OF THE EVIDENCE

Citation
Fa. Lederle et De. Niewoehner, LUNG-CANCER SURGERY - A CRITICAL-REVIEW OF THE EVIDENCE, Archives of internal medicine, 154(21), 1994, pp. 2397-2400
Citations number
34
Categorie Soggetti
Medicine, General & Internal
ISSN journal
00039926
Volume
154
Issue
21
Year of publication
1994
Pages
2397 - 2400
Database
ISI
SICI code
0003-9926(1994)154:21<2397:LS-ACO>2.0.ZU;2-A
Abstract
Surgery is generally considered to be the treatment of choice for anat omically localized non-small-cell lung cancer, but its effectiveness r emains unproven. Observational studies have been of limited value beca use the criteria by which patients are selected for surgery create sub stantial differences between patients who undergo surgery and those wh o do not. One small randomized trial of surgery vs radiotherapy was in conclusive, but several large trials of lung cancer screening have pro vided indirect evidence against a benefit from surgery. Two ongoing ra ndomized trials, one on extensive vs limited resection and the other o n the effect of surgery in more extensive disease, may provide further insight into the effectiveness of surgery in the treatment of localiz ed non-small-cell lung cancer. Development of a large randomized trial to directly assess the effectiveness of surgery in the treatment of l ocalized non-small-cell lung cancer has been precluded by ethical conc erns, but may need to be reconsidered if indicated by the findings of the two ongoing studies.