[Place of radical surgery in the treatment of non-small cell lung cancer. Apropos of 969 cases].
OBJECTIVE
Retrospective analysis of the results of radical surgery in a series of 969 patients presenting with non-small cell lung cancer.


METHODS
From April 1984 to December 1981, 969 patients underwent radical surgery with mediastinal node dissection for non-small cell lung cancer. Surgery included 507 pneumonectomies, 447 lobectomies and 15 segmentectomies (for patients suffering from respiratory failure).


RESULTS
The rate of intrahospital mortality was 4.3%. The rate of crude survival at 5-years was 45.8%. The tumor size (P = 0.004) and visceral pleura ruptures (P = 0.01) were significantly correlated to the 5-year survival rate that was reaching 56% for patients with no demonstrable metastasis to regional lymph nodes (NO), 46.6% for patients with metastasis to lymph nodes in the peribronchial or the ipsilateral hilar region (N1), and 20.8% for patients with metastasis to the ipsilateral mediastinal and subcarinal lymph nodes (N2) (P = 0.001). In case of stage N2 cancer, the 5-year survival rate was 28.7% when only one anatomical level was involved, and 8.7% when more than one anatomical level was involved (P < 0.0001).


CONCLUSIONS
The main prognostic factor was nodal involvement.
Riquet
M
M
Service de chirurgie thoracique, hôpital Laënnec, Paris, France.
Manac'h
D
D
Dujon
A
A
Le Pimpec-Barthes
F
F
Debrosse
D
D
Debesse
B
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002283:Carcinoma, Bronchogenic / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome