Dr. DeCamp on Platforms of Surgical Management in Lung Cancer

Malcolm McAvoy DeCamp, Jr, MD, chief of Thoracic Surgery in the Department of Surgery, Northwestern University Feinberg School of Medicine, discusses different platforms of surgical management in the treatment of patients with lung cancer.

In the minimally invasive area, says DeCamp, there are 2 major platforms for the management of surgically resectable lung cancer. Currently, the most commonly practiced one is video-assisted thoracic surgery (VATS). The newer, less commonly practiced modality is robotic-assisted thoracic surgery. According to DeCamp, approximately 20% to 25% of cases of lobectomy for lung cancer are performed with VATS across the United States annually, while only about 8% or 9% are treated with RATS. Taken together, says DeCamp, that is still less than one-third of the total resections being performed in the country in a minimally invasive manner.

DeCamp is surprised that these modalities are not more widely adopted in practice, as it is quite clear that patients enjoy a better quality of life. They experience shorter lengths of stay in the hospital, fewer complications following lobectomy, an earlier return to functional status, or even earlier availability to receive additional treatments such as adjuvant chemotherapy, if it is necessary.

DeCamp believes that this underscores the fact that, in the United States, most thoracic surgery is performed not by dedicated general thoracic surgeons, but by cardiothoracic surgeons that have more of a major focus in heart surgery, or even general surgeons that only have some experience in general thoracic procedures. Patients would likely be better served by surgeons whose disciplines are specifically focused in thoracic surgery, says DeCamp,.