Situation

What would you do in the following situations ?

1 Macroscopic positive resection margin at time of surgery

2 Microscopic positive resection margin

3 Pathology report of microscopic positive N2 disease

4 Oat cell on pathology report after T1N0 RLL on undiagnosed pulmonary nodule

 

Opinion

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Opinion

1 Macroscopic positive resection margin at time of surgery

Obviously if fit enough resect more, however may not be possible so postoperative radiotherapy may be needed.

 

2 Microscopic positive resection margin

Debatable, but postoperative radiotherapy may play role in controlling local recurrence.

 

3 Pathology report of microscopic positive N2 disease

Again debatable, but postoperative mediastinal radiotherapy may play role in controlling local recurrence.

 

4 Oat cell on pathology report after T1N0 RLL on undiagnosed pulmonary nodule

Needs postoperative chemotherapy