Letters to the Editor Letter to the Editor Surgery for T4 non-small cell lung cancerq

We read with interest the recent article [1] in the journal on surgical resection of T4 non-small cell lung cancer (NSCLC). We agree with Pitz et al. that T4 tumors are a heterogeneous group of tumors and need to be treated on an individual basis. Thoracic surgeons and oncologists should understand that not all T4 tumors are to be considered similar to the clearly more advanced N3 disease (both stage III B) and treated with palliative intent. However, we feel that the article should have emphasized that the 89 patients considered in the study constitute a highly selected group. Rather than the 2009 consecutive patients with NSCLC treated with surgical resection in the department, a more valid statistic would be the total number of T4 NSCLC patients who presented to the department over the same timeframe. This would give a realisti