Our Summary

This study looked at whether surgery after chemoradiotherapy (a combination of chemotherapy and radiation therapy) is more effective than just chemoradiotherapy in treating patients with a specific type of advanced lung cancer. The researchers did not find a significant difference in survival rates between the two groups, except in one case where patients who had a type of surgery called a lobectomy after chemoradiotherapy lived longer without the cancer getting worse. Patients who underwent a lobectomy also had fewer deaths related to the treatment than those who had a different type of surgery called a pneumonectomy. This suggests that for patients with this type of lung cancer, having surgery after chemoradiotherapy may be beneficial, but only if they do not need a pneumonectomy.

FAQs

  1. Does surgery after chemoradiotherapy improve survival rates in patients with advanced lung cancer?
  2. What is the difference in survival rates between patients who underwent lobectomy and those who underwent pneumonectomy after chemoradiotherapy?
  3. Is surgery recommended after chemoradiotherapy for all types of lung cancer?

Doctor’s Tip

The doctor may advise the patient to carefully follow all pre-operative instructions, including abstaining from smoking, maintaining a healthy diet, and staying physically active. After surgery, the doctor may recommend pulmonary rehabilitation to help improve lung function and overall recovery. It is important for the patient to attend all follow-up appointments and adhere to any prescribed medications or therapies to ensure the best possible outcome.

Suitable For

Patients who are typically recommended lung surgery include:

  • Patients with early stage lung cancer that has not spread beyond the lung
  • Patients with limited stage small cell lung cancer
  • Patients with advanced stage lung cancer who have a good performance status and are otherwise healthy enough to undergo surgery
  • Patients with certain types of advanced lung cancer who have responded well to chemoradiotherapy and may benefit from surgery as part of their treatment plan

It is important for patients to discuss their individual case with their healthcare provider to determine if lung surgery is the best course of action for their specific situation.

Timeline

Before lung surgery:

  1. Patient is diagnosed with lung cancer and undergoes various tests to determine the stage and extent of the disease.
  2. Patient may undergo chemotherapy and/or radiation therapy as part of their treatment plan to shrink the tumor and reduce the risk of spreading.
  3. Patient is evaluated by a surgical team to determine if they are a candidate for surgery, based on factors such as the size and location of the tumor, overall health, and ability to tolerate surgery.
  4. Patient undergoes pre-operative preparations, which may include further testing, consultations with various specialists, and education about the surgery and recovery process.

After lung surgery:

  1. Patient undergoes the surgical procedure, such as a lobectomy or pneumonectomy, to remove part or all of the affected lung.
  2. Patient recovers in the hospital for several days to weeks, depending on the extent of the surgery and any complications that may arise.
  3. Patient may experience pain, shortness of breath, and other side effects of the surgery, which are managed through medication and supportive care.
  4. Patient undergoes follow-up appointments with their surgical team to monitor their recovery, address any concerns or complications, and discuss further treatment options if needed.
  5. Patient may undergo additional treatments, such as chemotherapy or radiation therapy, to further reduce the risk of cancer recurrence.
  6. Patient undergoes regular follow-up appointments and imaging scans to monitor for any signs of cancer recurrence and to ensure long-term recovery and well-being.

What to Ask Your Doctor

  1. What type of lung surgery do you recommend for my specific type of lung cancer?
  2. What are the potential risks and complications associated with the surgery?
  3. What is the expected recovery time and rehabilitation process after the surgery?
  4. How will the surgery impact my quality of life and daily activities?
  5. What are the long-term effects of the surgery on my overall health and lung function?
  6. Are there any alternative treatment options to surgery that I should consider?
  7. How many of these surgeries have you performed, and what is your success rate?
  8. Will I need any additional treatments or therapies after the surgery?
  9. How will the surgery be performed (open surgery, minimally invasive surgery, robotic surgery)?
  10. What are the chances of the cancer recurring after the surgery?

Reference

Authors: Swaminath A, Vella ET, Ramchandar K, Robinson A, Simone C, Sun A, Ung YC, Yasufuku K, Ellis PM. Journal: Curr Oncol. 2019 Jun;26(3):e398-e404. doi: 10.3747/co.26.4549. Epub 2019 Jun 1. PMID: 31285684