Treatment of peripheral early stage lung cancer.

Not only is the incidence of lung cancer increasing around the world, this disease has become the leading cause of cancer death. Since lung cancer kills 85% to 90% of its victims, it is recognized as one of the most difficult to cure diseases. Although the therapeutic results are quite unsatisfactory as a whole, earlier stages of lung cancer, stages IA and IB show better therapeutic results (Table 1). To improve the therapeutic results of lung cancer, efforts for early detection and treatment are essential. In our institution, the 5-year survival rate has gradually improved over the past five decades. These results could be due to improvement of therapeutic procedures including surgery, chemotherapy, radiotherapy, laser therapy and immunotherapy. Furthermore, the improvement of survival may be partially due to lung cancer mass screening made by the Health Insurance Act of 1987. Lung cancer mass screening by chest computed tomography (CT) was begun in Japan 10 years ago and now is becoming subsequently used in the United States and Europe. Since large numbers of peripheral tiny lung shadows were detected in many of the CT screening pilot trials, it is important to establish an internationally accepted definition of peripheral type early stage lung cancer. In this editorial the authors describe the present status and prospects for the treatment of early stage lung cancer.