A 62-year-old male smoker presents with right anterior chest pain. There is a 3 cm mass attached to the chest wall with radiographic evidence of rib erosion and positive cytology for non-small cell carcinoma. Which of the follow is/are true:

c. Operative resection should be performed with en bloc removal of the tumor and adjacent chest wall as well as a mediastinal lymph node resection

e. The patient would be classified Stage IIIa

Survival after resection for non-small cell lung cancer is related to the stage of the disease with a strong adverse effect from nodal involvement. This is true even for large peripheral tumors that extend into the chest wall as in this case where a 40– 50% survival would be expected in the absence of nodes (T3N0:Stage IIIa) but only a 15% survival with nodal involvement. Radiation therapy would be a postoperative consideration to reduce the incidence of local recurrence. En bloc operative resection of the involved lobe and mediastinal nodes for staging would offer the greatest likelihood of cure.