Practice guidelines for lung cancer invading the neighboring anatomic structures

Lung cancers invading the neighboring anatomic structures such as the chest wall, diaphragm, great vessels (superior vena cava, aorta, left atrium, etc.), and tracheal carina are categorized as T3 or T4, and are regarded as locally advanced lung cancer. The surgical indications mode of resection, and combined treatment for these tumors have been important issues. However, the scientific evidence from comparative studies, which serve as the basis for practice guidelines is very scant for these categories of tumor. Although surgical interventions are favored for tumors simply invading the chest wall, the combined resection of the great vessels is not standardized. The further refinement of scientific evidence that justifies the therapeutic strategy is necessary, especially for these tumor categories.