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Ann Thorac Surg 2003;76:185-186
© 2003 The Society of Thoracic Surgeons

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Original article: general thoracic

Invited commentary

^a Head Section General Thoracic Surgery, Virginia Mason Clinic, 1100 Ninth Avenue, Seattle, WA 98111-0900, USA

e-mail: donald.low@vmmc.org

The first 20% of the full text of this article appears below.

The paper by Greason and colleagues reviews the important issue of minimizing complications and costs in the management of patients receiving neoadjuvant radiotherapy prior to surgical resection for advanced lung cancer. This review is pertinent due to increasing indications that neoadjuvant therapy, either chemotherapy alone or chemoradiotherapy, can impact outcomes, including resectability and survival, in patients with III-A, III-B, and localize stage IV disease. The current review suffers from being a nonrandomized comparison of outcomes in patients undergoing lobar resection following neoadjuvant radiotherapy. The authors go to great lengths to demonstrate that the three comparative groups, ie no bronchial coverage, coverage with mediastinal tissue, and coverage with serratus anterior, are similar in presentation and radiation dosage. However, in each individual patient’s case, the ultimate decision regarding bronchial coverage was left to surgical judgment. . . . [Full Text of this Article]