Dr. Molena on Determining Surgical Resection Eligibility in NSCLC

Daniela Molena, MD, director, Esophageal Surgery Program, Memorial Sloan Kettering Cancer Center, discusses factors that determine if a patient with non—small cell lung cancer (NSCLC) is eligible for surgical resection.

Early-stage lung cancer is curable with surgery, explains Molena. If a high-risk patient presents with a nodule on their CT scan, it should not be ignored because it could progress into later-stage disease and render the patient ineligible for surgical resection.

Other factors such as the patient’s functional status and ability to tolerate anesthesia also determine if surgery is an option, says Molena.

The majority of patients with NSCLC have some degree of lung damage caused by smoking, explains Molena. As such, determining how much of the lung can be resected is another important consideration. In some cases, compromise must be made to ensure that enough lung can be removed without jeopardizing the patient’s postoperative function, says Molena.

For example, lobectomy remains the standard surgery for this patient population, says Molena. However, if a patient has low borderline pulmonary function and small cancer, less of the lung may be taken.