The Ability of Surgery in T4 Lung Cancer

According to the staging system, T4 cases have been identified as tumors larger than 7cm or invasive tumors on tissues, suchas the diaphragm, mediastinum, heart, large vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral body, or separatetumor nodule(s) on a different lobe on the same side. In this manuscript, the srugical treatment of T4 N0-1 lung cancer that madetracheal, carina, vertebra, thoracic inlet, vena cava superior, mediastinal structures and diyafragmatic invasion. Medical literaturein the thoracic surgery and oncology network was reviewed, and studies, cases, and meta-analysis studies that included surgicaltreatment practices in oligometastatic small cell lung cancer treatment and their results were examined. A discussion was made byalso analyzing the survival data in light of the literature studies and available guidelines. In recent years, indications of lung cancersurgery have also been expanded in parallel with the advancements in multidisciplinary surgery and in multidisciplinary oncologicaltreatment protocols, and thus surgery has become applicable for more patients. T4 N 0-1 cases are approximately 30 % of alllung cancer cases and despite 5 year survival is about 10 %, there are survival advantages in patients who have complete resection.T4 tumor surgery should be applied in experienced centers and by multidisciplinary surgery teams. Treatment decisions should beindividualized, and complete surgery should be considered for NO-1 cases whose activity rate could be high.

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