Salvage Resection After Definitive Radiation Therapy for Stage I Non-small Cell Lung Cancer

Definitive radiation is an alternative to surgical resection for early stage non-small cell lung cancer. This management option is generally recommended for non-operable patients, but can also be used for operable patients who wish to avoid surgery. Stereotactic radiation for stage I lung cancer is associated with reasonably good survival, but does have local or regional failure rates of 10–25%. Salvage resection can offer patients not only prolonged survival but also a chance of cure, but patients must be very carefully evaluated and selected as appropriate for surgery. Although evidence to guide management is limited to small retrospective and non-controlled case series and therefore low quality, published studies do suggest salvage surgery after definitive radiation can be performed with good peri-operative outcomes and good oncologic outcomes in appropriately selected patients.