Apparently operable NSCLC: It appears that T1 and T2 lesions with no evidence of mediastinal adenopathy on CT scan do not require more invasive staging. This does not appear to increase the incidence of ‘nontherapeutic’ thoracotomies or decrease the cure rate . Staging of T3 lesions without evidence of adenopathy is controversial. Survival is markedly reduced in T3N2 stage IIIA tumours, and if a particular centre plans induction regimens for these patients, biopsy of the upper mediastinal N2 nodes should be performed routinely . Other centres prefer to go straight to thoracotomy, with plans for complete mediastinal node dissection and adjuvant therapy, although there is no proven survival benefit .
Apparently inoperable NSCLC: Curative resection should not be withheld on the basis of indeterminate radiographical findings alone. Central lesions that appear to invade the mediastinum but are otherwise operable may require thoracotomy for definition . Occasional survivors are reported from minimal resection of the vena cava, aorta, esophagus, atrium and vertebral body . Prethoracotomy mediastinoscopy should be performed where this possibility is suggested by CT scan because central T3N2 and T4N2 lesions treated by resection alone are associated with essentially no chance of five-year survival. Your health is the most precious thing you own, so taking care of it is always important. The best the canadian family pharmacy is now at your service offering finest quality drugs with discounts and fastest delivery possible.