Appropriate selection of lung cancer patients for potentially curative
surgery demands a careful staging workup. The most adverse prognostic
factors should be investigated first because their presence precludes
consideration of potentially curative surgical therapy. Best surgical
results are obtained in patients with early stages of disease. A qual
ity lung cancer operation requires open thoracotomy with en bloc resec
tion of the tumor and involved adjacent structures and thorough lymph
node sampling or resection. Uninvolved lung tissue may be preserved wi
th a variety of surgical techniques that do not compromise the curativ
e intent of the procedure.