集学的治療における完全胸腔鏡下手術の役割

The Role of Video-assisted Thoracic Surgery in Multimodality Therapy

胸腔鏡下手術の普及により，外科治療の低侵襲化は確実にすすんでいる．化学療法，放射線治療についても同様に身体的負担が少ない治療が可能となっており，進行肺癌の治療成績向上に向けて集学的治療の重要性は日々増している．また最近では分子標的治療だけでなく，免疫チェックポイント阻害薬の登場により集学的治療の治療戦略は次々と考案されている．今後，肺癌に対する治療戦略および治療成績が大きくかわる可能性があり，集学

Minimally invasive surgery is being widely performed for the management of lung cancers owing to rapid technological advances in surgical devices and techniques. In recent times, because chemotherapy and radiotherapy have both become less invasive treatment strategies, therapeutic opportunities for the use of multimodality therapy have been increasing. Minimally invasive surgery is an important component that requires additional improvements to derive the complete benefit of multimodality therapy. We have been actively performing video-assisted thoracic surgery（VATS） for the management of advanced lung cancers, as well as early lung cancers to reduce surgical stress in our patients, thereby enhancing the scope of multimodality therapy. Although some reports have demonstrated the efficacy of VATS for the management of early lung cancers, only a limited number of reports have discussed the advantage of VATS for the management of advanced lung cancers. In this report, we reviewed patients with advanced lung cancer （pathological stageⅡ or Ⅲ） in whom complete resection was performed between January 2011 and December 2016, and we examined the role of VATS as a component of multimodality therapy.