Surgical Treatment of Primary Lung cancer

Na, Kook Joo; Ahn, Byeong Hee; Kim, Sang Hyung

Abstract

BACKGROUND: It is clearly evident that surgical resection offers the best opportunity for cure of non-small cell carcinoma. However, the results in surgical treatment of primary lung cancer are not satisfactory.
METHODS
This study was designed to analyze the clinical data of 169 primary lung cancer patients who underwent surgical resection from March, 1986 to December, 1997 at the department of Thoracic and Cardiovascular Surgery, Chonnam University Hospital.
RESULTS
There were 140 males and 29 females (4.8: 1). In the age distribution, the peak incidence was recorded in the seventh decade (40%). Seventy-seven pneumonectomies, 61 lobectomies, 17 bilobectomies, 14 sleeve lobectomies were performed. Operative mortality occured in 3 cases due to respiratory failure. The histologic types of tumor were 111 squamous cell carcinomas, 42 adenocarcinomas, 3 large cell carcinomas, and 6 adenosquamous cell carcinoma. The primary tumors were in the right upper lobe in 38 patients, the right middle in 20 patients and right lower lobe in 36 patients, the left upper lobe in 49 patients, and the left lower lobe in 26 patients. The histologic types of sixty-nine patients with mediastinal lymph node metastases were 43 squamous cell carcinomas, 20 adenocarcinomas, 3 large cell carcinoma and 3 adenosquamous cell carcinoma. The overall actuarial survival rate was 56.7% at 24 months and 43.2% at 60 months. The actuarial survival rates at 60 months were 80.0% in Stage Ia, 75.1% in Stage Ib, 43.0% in Stage IIb. 32.4% in Stage IIIa, 37.5% in Stage IIIb and 0% in Stage IV. The prognostic factors influencing to survival were cell type, tumor status, node status, TNM stages and complete resection.
CONCLUSION
These facts suggest that early detection and complete surgical resection are recommended for favorable postoperative survival in non-small cell lung cancer.