Lung Cancer.pdf

110 W.R. Smythe
Figure 6–1. Postsurgical complications in patients with NSCLC treated at M.D.
Anderson with and without neoadjuvant chemotherapy. Reprinted with permission
from Smythe WR. Treatment of stage I and II non-small-cell lung cancer. Cancer
Control 2001;8:318–325.
lowed by surgery versus surgery alone—the “BLOT or KNOT” trial (intergroup
S9900) is now under way.
Postoperative Management
In patients with early-stage NSCLC treated with surgery, a careful pathologic
examination of the tumor specimen and the lymph nodes removed
at the time of surgical resection of the primary tumor is extremely important.
Occasionally a malignancy other than NSCLC is diagnosed, and this
may dictate additional therapy or clinical evaluation (examples include
small cell lung carcinoma or findings suggesting a metastatic lesion
rather than a primary lung tumor). In addition, it is important to determine
whether all the resection margins are negative for tumor involvement
at the microscopic level and whether occult metastatic disease is
present in the mediastinal lymph nodes. In the case of a microscopically
positive margin, targeted postoperative adjuvant radiation therapy
would be recommended as studies have shown that such treatment may