Surgery for Lung Cancer

The goal of surgery for lung cancer is to remove all of the cancer. Your MSK surgeon’s top priority is to keep you safe and make sure you have a good quality of life after the procedure.

Successful surgery requires removing the portion of the lung containing the cancer and the adjacent lymph nodes (also called lymph glands). Lymph nodes in the chest trap cancer cells as they leave the lungs and are frequently the first site to which lung cancer spreads.

How much of the lung is removed depends on many factors, including the size and location of the tumor, whether the cancer has been found in the surrounding lymph nodes, and your overall health and strength (particularly your lung and heart function).

Thoracoscopy
Our surgeons are highly experienced in doing a minimally invasive procedure known as thoracoscopy (also called video-assisted thoracic surgery, or VATS).
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As a surgical patient at MSK, you will be cared for by one of the most experienced lung cancer teams in the United States. Our surgeons perform more than 1,200 lung cancer operations each year, and our patients have among the lowest complication rates after surgery in the country.

Our surgeons offer lung-sparing surgery to remove the cancer and preserve remaining lung tissue whenever possible. We also recommend less-invasive techniques whenever we can, including something called thoracoscopy, which can allow you to recover more quickly than traditional open surgery.

How much tissue our surgeons need to remove will depend on the type of lung cancer you have and how far it has advanced.

If you have non-small cell lung cancer that has not spread beyond one lung, surgery to remove the tumor completely provides the best chance for a cure. Lobectomy is the most common type of operation for people with this kind of lung cancer. People with early-stage non-small cell lung cancer who are not candidates for surgery are typically treated with stereotactic body radiation therapy, a treatment that offers excellent long-term chances to eliminate small lung lesions.

If you have advanced non-small cell lung cancer that has spread to your lymph nodes but is still confined to your chest, and you cannot be treated surgically either because of your tumor’s location or because of your health, we may recommend radiation therapy. It’s ideally given with chemotherapy either at the same time or before or after radiation therapy.

Surgery is rarely part of the treatment plan for small cell lung cancer because the disease tends to spread quickly and responds well to chemotherapy and radiation therapy. In certain cases, however, particularly if the cancer is identified at an early stage, surgery to remove small cell tumors can be an option. MSK surgeons are skilled in removing small tumors, including those that are located near the exterior of the lung and those that have not spread beyond the lung.

Patients who are able to have surgery for small cell lung cancer typically receive adjuvant chemotherapy (chemotherapy given after surgery). This approach has been shown to improve cure rates when compared with surgery alone.

3 Common Types of Lung Cancer Surgery

Three surgical procedures are commonly used to treat lung cancer. Which operation is performed depends on how large the tumor is and where it has spread within the lungs.

Sublobar operations include surgery to remove parts of the lung within one of the lobes. (There are three lobes in the right lung and two in the left lung.) This approach may involve removing a small section of the lung (called wedge resection), or removing one or more anatomic sections within a lobe (called segmentectomy). These operations are performed either when the tumor is very small or when a larger lung removal would be too physically stressful for the patient.

Lobectomy is the most common operation performed for non-small cell lung cancer and is the best treatment for an isolated lung cancer in an otherwise healthy patient.

A lobectomy is the removal of a complete lobe of the lung. (There are three lobes in the right lung and two in the left lung.) This is the most common operation performed for non-small cell lung cancer and is the best treatment for an isolated lung cancer in an otherwise healthy patient. A bilobectomy involves the removal of two lobes of the right lung (the upper and middle lobes or the middle and lower lobes).

A pneumonectomy is the removal of an entire lung. It is performed when the cancer is located in the center of the lung and cannot be removed using a more localized operation. A pneumonectomy is only performed in patients who have good lung function and could recover and live without the need for supplemental oxygen. Fortunately, our surgeons rarely need to perform a pneumonectomy to remove lung cancer.