Surgical treatment of locally advanced T4 non-small cell lung cancer with mechanical circulatory support

: T4 non-small cell lung cancer (NSCLC) is a very heterogeneous group of locally advanced neoplasm greater than 7 cm or characterized by at the least one following: more satellite tumor nodules in different ipsilateral lobe invasion trachea, carina, heart, great vessels, vertebral body, oesophagus, mediastinum. Because location and surrounding structures, controversy exists surgical resection tumours which are usually considered unresectable incurable. For long time, radical extended these tumours, needing removal tissues beyond physical boundaries standard lobectomy pneumonectomy, has been as an obstacle. At same time introduction techniques, often including use extracorporeal life support (ECLS), allowed to extend limits conventional surgery increasing rate complete resection. Thanks experience gained during transplantation, surgeons now using such methods obtain good oxygenation hemodynamic complex resections tumours. The aim this paper was perform critical review state art treatment for NSCLC with ECLS. Concerning two categories (tumors reaches heart vessels tumors presenting carina extension) may need ECLS, we analysed indications, choice suitable device, short- long-term results.