Stage II and III-A non-small cell cancer of the lung: results of surgical resection at Fairfax Hospital.
Carcinoma of the lung is the single leading cause of death in patients with cancer and is responsible for over a quarter of all such deaths. Encouraging survival rates have been demonstrated following surgical resection of local (Stage I) disease. This paper details the results achieved with surgical resection of 100 patients with more advanced local--regional non-small cell carcinoma of the lung (Stages II and III-A). Operative (30-day) mortalities were 2.4% for Stage II patients and 8.5% for Stage III-A patients. Respective, 5-year Kaplan-Meier survival estimates were 41% (+/- 10%) and 36% (+/- 7%) and included all deaths, cancer-related as well as unrelated. When patients were stratified by stage, neither gender, age, cell type, tumor size, nor extent of resection proved statistically significant relative to long-term survival. However, Stage III-A patients, classified T-3 with contiguous tumor involvement of mediastinum, suffered a higher operative mortality and a significantly lower probability of long-term survival (p = 0.04). Finally, the results and appropriateness of prospective, clinical trials utilizing adjuvant therapies in Stage II and III-A patients and neo-adjuvant therapies in Stage III-A patients are discussed.
Kiernan
P D
PD
Department of Surgery, INOVA Health System, Fairfax Hospital, Annandale 22003.
Sheridan
M
M
Byrne
W D
WD
Fulcher
T
T
Attai
D
D
Seigel
L
L
Hull
M
M
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012737:Sex Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome