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Lobe and Lung Removal: Lobectomy and Pneumonectomy

Surgery that removes the tumor and surrounding tissue offers the best chance of recovery.
However, surgical treatment has some very real restrictions. Tumor size, metastasis to the
lymph nodes, and the type of cancer must all be considered.

Non Small Cell Lung Cancer

Early stage non small cell lung cancer (NSCLC) is usually the only form of the disease
treated with surgery. Small cell tumors (SCLC), unless detected in their earliest stages, are
usually too far advanced at the time of diagnosis.

Stage 1 and 2 non small cell lung cancer have the best surgical prognosis: according to a
Swedish study, five year survival rates average between sixty to seventy percent. Stage 3
NSCLC sometimes meets the criteria for surgery, but survival rates drop to ten to twenty
percent.

Other Considerations

Tumor location determines, in part, if surgery is possible. Malignant growth too close to the
heart, windpipe or other important organs may make operating too risky. If the disease has
spread to the lymph nodes or to other organs, a lobectomy, or even complete lung removal,
will not improve survival rates. Chemotherapy and radiotherapy are possible alternatives in
these cases.

Types of Surgery

Wedge Resection and Segmentectomy
A wedge resection is performed if the tumor is confined to one area of the lung. This
procedure removes only the tissue affected. Should a larger section need to be removed, the
procedure is called a segmentectomy.

Lobectomy
The lungs are composed of sections called lobes. A lobectomy removes an entire lobe. By
removing the entire lobe, the lobectomy hopefully removes all traces of cancer cells.
Surrounding lymph nodes may be removed at the same time in a procedure called a
lymphadenectomy.

Pnumonectomy
A pnumonectomy removes an entire lung. Removal may be called for if cancer appears to have
spread throughout the entire organ, but the exact location is hard to pinpoint. People often
worry that their breathing will be compromised after lung removal, but the remaining lung is
usually more than sufficient.

Surgical Complications

As with any surgery, cancer surgery carries potential complications: internal bleeding and
infection are possible. A condition called lymphocytopenia may also occur. Lymohocytopenia is
a chronically low white blood count. The condition has been noted in cases of advanced lung
cancer, and appears to lower survival rates.

Finally, any candidate for surgery must understand that a possible relapse may occur.
Removing all malignant cells is extremely difficult. Tumor regrowth, or metastasis to other
organs is possible. The earlier the tumor is removed, the less likely the chance relapse.