In the following article Dr. Molins López-Rodó explains his approach to lung cancer.
What is the difference between pneumonectomy, lobectomy and segmentectomy and in which case would one or the other be used?
Pneumonectomy is the removal of the entire lung, lobectomy is the removal of one of its lobes and segmentectomy is the removal of less than one lobe, what we call a lung segment. One or the other intervention is used depending on the size and location of the tumor to be removed. If it is central and large, in many cases a pneumonectomy must be performed, although there are surgical techniques (bronchoangioplasties) to try to avoid it. Lobectomy is the most frequent intervention when the tumor is located in one of the five pulmonary lobes and segmentectomy is performed when the patient has little respiratory capacity and/or the tumor to be treated is less than 2cm in diameter.
What are the characteristics of N2 lung cancer?
N2 means that the tumor has spread to the surrounding lymph nodes, more specifically in the mediastinum, which is the drainage area of the lung (similar to the axillary nodes in breast cancer). In these cases, the prognosis is worse and treatment is started with chemotherapy and radiotherapy to later evaluate if it can benefit from surgical treatment.
Can surgery be applied at this level of lung cancer?
This is one of the topics of my paper, in which I present the existing evidence regarding the benefit of surgery in these selected patients.
What are the complications of surgery at these levels?
Complications are not greater than those of surgery without lymph node involvement.