Survival and prognosis following resection of primary non small cell bronchogenic carcinoma

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Abstract
A prospective follow up was carried out on 479 consecutive patients whounderwent lung resection for non small cell primary bronchogenic carcinomabetween 1980 and 1987 under the care of one surgeon at Guy's Hospital andBrook Hospital, London. The mean age of patients was 61.8 years; 16.9% wereaged 70 years or over. Of the 479,237 patients had stage I disease, 108patients stage II disease, and 134 patients stage III. Lobectomy wasperformed in 280 patients, pneumonectomy in 191, and wedge resection in 8.Operative mortality was 5% overall, 6.8% following pneumonectomy and 3.9%following lobectomy. There was no operative mortality following wedgeresection. Old age did not affect operative mortality. Overall actuarialsurvival was 76.2% and 39.8% at 1 year and 5 years postoperatively,respectively (stage I: 86% and 55%; stage II: 77.8% and 35.5%; stage III:57.5% and 16.2%). There were statistically significant differences insurvival between the stages. Five-year actuarial survival was 45% forsquamous cell carcinoma, 36.3% for adenocarcinoma, 31.9% for dimorphiccarcinoma and a 21% for undifferentiated carcinoma. There werestatistically significant differences in survival between undifferentiatedcarcinoma and each of the other cell types. The favourable survival instage I disease lends weight to the concept that there is hope for cure inpatients with early non small cell lung cancer.

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