The same team of pneumonologists, thoracic surgeons and anesthesiologists/intensive care physicians will be involved in the perioperative medical management. In addition to history and clinical examination, a standardized preoperative assessment includes chest radiography, ECG, pulmonary function testing as well as computed tomography scans and positron emission tomographies of the chest, abdomen and brain. Quantitative lung perfusion/ventilation scanning, brain imaging, maximal aerobic capacity and myocardial stress testing will be performed when appropriate in intermediate-to-high risk surgical candidates.