Surgical results for the treatment of primary carcinoma of the lung.
In order to examine the effectiveness of surgical therapy for primary lung carcinoma, 200 surgical patients were reviewed. Survival rates were compared to the initial operative approach, the tumor stage, and the histological type. The five year survival rate was 62% for Stage 1 tumors, 60% for Stage 2, 21% for Stage 3 and 32% for Stage 3 when metastases were confined to the ipsilateral hilar lymph nodes. The most profound influence on prognosis was exerted by the presence or absence of metastases to the mediastinal lymph nodes. Other factors such as tumor size, histological type, and degree of differentiation did not appear to affect prognosis. With extended resections of the adjoining organs, a 5 year survival rate of 37% was obtained in patients in whom the carcinomatous infiltration did not extend beyond the boundaries of the aortic adventitia, pleura, or pericardium. However, it was 0% when this boundary was broken. The CT scan was found to be helpful in the preoperative identification of carcinomatous infiltration. In some patients with preoperative CT scans demonstrating limited infiltration, the left atrium or aorta was resected and satisfactory long term survival was obtained. Finally we examined the effectiveness of the addition of radical lymphadenectomy of the right mediastinal nodes during the treatment of left lung carcinoma. This was performed by adding a median sternotomy to the standard left thoractomy and was well tolerated.
D000230:Adenocarcinoma / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis