8 (follow up of non small cell lung cancer). 2.3 CLINICAL STAGE IIA 2.3.1 Anatomical surgical resection with lobectomy or pneumonectomy and mediastinal lymph node sampling (EL-1) or dissection (EL-3). 2.3.2 Offer adjuvant therapy as per 2.2.3 (EL-1). 2.3.3 PD-0332991 price If optimal surgery cannot be performed, consider limited surgery (wedge resection or segmentectomy) (EL-1). 2.3.4 For positive surgical margins perform re-resection (EL-1) and if not possible, offer curative radiotherapy (EL-2). 2.3.5 If surgical resection is not possible, offer curative radiotherapy (EL-1). 2.3.6 Follow up and surveillance per Section 2.8 (follow up of non small cell lung cancer). 2.4 CLINICAL STAGE IIB 2.4.1 Anatomical surgical resection
and mediastinal lymph node sampling (EL-1) or dissection (EL-3). find more 2.4.2 Offer adjuvant therapy similar to 2.2.3 (EL-1). 2.4.3 Superior sulcus tumors patients should be induced by cisplatin/etoposide with concurrent radiation therapy followed by surgical resection (EL-2). Assess disease extent by using MRI at baseline and pre-operative. 2.4.4 For T3 N0 M0 perform en-bloc resection (EL-1). 2.4.5 If optimal surgery cannot be performed, consider limited surgery (wedge resection or segmentectomy) (EL-1). 2.4.6 For positive surgical margins perform re-resection (EL-1) and if not possible, offer curative radiotherapy (EL-2). 2.4.7 If surgical resection is not possible, offer curative radiotherapy
(EL-1). 2.4.8 Follow up and surveillance per Section 2.8 (follow up of non small cell lung cancer). 2.5 CLINICAL STAGE IIIA 2.5.1 For T3 N1 M0 perform en-bloc resection (EL-1). 2.5.2 For superior sulcus tumor, offer treatment similar to 2.4.3 (EL-2). 2.5.3 For N2 disease offer neoadjuvant concurrent chemo-radiotherapy
(EL-1) assess response. If resectable, offer surgery. For non-resectable tumors, continue with the appropriate treatment based on disease status. 2.5.4 If positive N2 disease discovered during surgery by frozen section abort surgery if pneumonectomy is required (EL-2). 2.5.5 Incidental pathological N2 disease, adjuvant chemotherapy is indicated (EL-1) radiotherapy can be considered (EL-3). 2.5.6 For T4 (2 nodules in ipsilateral separate lobes), offer pneumonectomy followed by adjuvant chemotherapy. to 2.5.7 T4 (mediastinal involvement or main airway involvement), offer surgery if potentially curative, if not possible, offer definite concurrent chemoradiotherapy (2.5.1) 2.5.8 For non N2 stage IIIA, not specified above, offer surgical resection with adjuvant chemotherapy (EL-1). Adjuvant radiotherapy may be considered (EL-3). 2.5.9 Follow up and surveillance per Section 2.8 (follow up of non small cell lung cancer). 2.6 CLINICAL STAGE IIIB AND UNRESECTABLE IIIA 2.6.1 Offer concurrent chemo-radiotherapy (EL1) followed by chemotherapy (EL2). Surgical resection for selected cases can be offered. 2.6.2 Follow up and surveillance per Section 2.8 (follow up of non small cell lung cancer).