As a malignant tumor with the highest incidence and mortality rate, lung cancer has attracted much attention due to its increasing number of patients year by year. How to formulate reasonable treatment plans for the best treatment outcome in a more scientific and standardized way, how to maximize the disease-free survival time of patients, and how to ensure the best postoperative quality of life of patients is now an urgent issue that every lung cancer doctor must solve, and it is also an important issue that lung cancer patients and their families should recognize and understand.
Standardized treatment is an important issue in the world, and it is also a difficult problem in China. In clinical practice, the same film and the same patient are treated differently by three or four or five authoritative experts, and the treatment methods are different or even opposite. Patients are often confused when seeking medical treatment, and inevitably, they have to turn to doctors for treatment, while doctors in different hospitals have different knowledge about lung cancer disease, which also causes irregular treatment of lung cancer to a certain extent.
In order to prolong patients’ lives and improve their quality of life as much as possible, it is necessary to combine the latest and most effective proven treatment methods and tailor them for each patient, so that each lung cancer patient can receive the best treatment, therefore, it is of great importance to promote comprehensive multidisciplinary treatment with surgery as the main treatment, i.e. standardized treatment of lung cancer.
I. What benefits does standardized treatment of lung cancer bring to patients?
1. standardized surgical treatment is the most important and critical treatment for lung cancer patients
2.Significantly improving the survival rate of patients.
3. prolonging the disease-free progression time and reducing the local recurrence rate
4.Minimizing the cases of tumor micrometastasis and complex cases such as jumping metastasis.
5.Provide more accurate clinical staging for doctors and patients, and provide accurate information for later treatment.
2. The following conditions are feasible for surgical treatment (indications for surgery).
1.Stage I, II and some stage IIIa non-small cell lung cancer and some small cell lung cancer.
2, N2 non-small cell lung cancer that is effective after neoadjuvant therapy.
3.Some stage IIIb non-small cell lung cancer if the tumor can be completely removed locally.
4.Some stage IV non-small cell lung cancer with single brain or adrenal metastasis.
5.Highly clinical suspicion of lung cancer, which cannot be diagnosed qualitatively by various examinations, it is recommended to refer to higher level hospitals for further consultation and treatment.
C. The following cases should not be treated surgically.
1.The vast majority of stage IV, most of stage IIIB and some of stage IIIA non-small cell lung cancer with clear diagnosis.
2. Those with poor cardiopulmonary function or combined with serious diseases of other important organ systems that cannot tolerate surgery.
IV. Irregular lung cancer treatment phenomenon that cannot be ignored
1.According to the standardized treatment criteria, patients who should have received surgical treatment do not undergo surgery, but instead undergo radiotherapy and chemotherapy, which makes patients miss the best time for surgery and adds extra burden.
2. patients with advanced disease who should not have received surgical treatment according to standardized treatment criteria underwent surgery instead
3. patients who were eligible and underwent surgical treatment, the resection of lung cancer lesions did not reach the standard of complete eradication, resulting in residual lesions and increasing the risk of intraoperative dissemination, postoperative recurrence, metastasis, etc.
4. incomplete lymph node dissection during surgical treatment, resulting in easy recurrence and metastasis of lung cancer after surgery
5. Patients with lung cancer who have undergone surgical treatment are not standardized to assess whether they need appropriate adjuvant therapy such as radiotherapy or targeted therapy after surgery, resulting in increased risk of tumor spread due to failure to consolidate treatment after surgery.