Surgical Management of Lung Cancer

Question 1

what features of a chest x ray would help in staging a patients lung cancer

Answer 1

is there pleural effusion
is there chest wall invasion
phrenic nerve palsy
collapsed lobe or lung

Question 2

what blood test information would help stage a patients lung cancer

Answer 2

have they developed anemia
abnormal liver function tests
abnormal bone profile

Question 3

why is a bone scan useful in lung cancer staging

Answer 3

good test for chest wall invasion and for bony metastases

Question 4

why is an echo useful in lung cancer staging

Answer 4

can confirm presence or absence of pericardial effusion

Question 5

when assessing a patients fitness for surgery in relation to lung cancer, what topics do you what to ask them about

Answer 5

do they have heart problem: HBP,PVD,smoking,stroke/TIA,previous angioplasty/CABG,murmurs

do they have any respiratory problems: barrell-chest, COPD, smoking, asthma, recurrent URTI, on O2, exercise capacity,

psych history

Question 6

what complications can lead to death after an operation for lung cancer

Answer 6

can develop bronchopneumonia
MI
Pulmonary thromboembolism
pneumothorax
intrathoracic bleeding 
Acute respiratory distress syndrome

Question 7

what causes acute respiratory distress syndrome

Answer 7

lungs become severely inflamed as a result of an infection or injury. The inflammation causes fluid from nearby blood vessels to leak into the tiny air sacs in your lungs, making breathing increasingly difficult.

Question 8

what are non fatal complications that can occur after lung cancer surgery

Answer 8

empyema 
wound infection 
Bronchopleural fistula
MI
post-op respiratory insufficency

Question 9

what are common problems faced when trying to stage lung cancer

Answer 9

1. collapse of lung can make the tumor hard to see
2. presence of another nodule could be the primary one too
3. tumor retrosternal

Question 10

what is the operative mortality of a pneumonectomy (whole lug removed)

Answer 10

8-12%

Question 11

what percent of patients with a T1N0 tumor survive 5 years post-op

Answer 11

70%

Question 12

what percent of patients with a T2N0 tumor survive 5 years post-op

Answer 12

60%

Question 13

what percent of patients with a T3N0 tumor survive 5 years post-op

Answer 13

50%

Question 14

what percent of patients with a T1N1/T2N1 tumor survive 5 years post-op

Answer 14

40%

Question 15

what percent of patients with a N2 tumor survive 5 years post-op

Answer 15

16%