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KMID : 0371319670090050259
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Journal of the Korean Surgical Society
1967 Volume.9 No. 5 p.259 ~ p.264
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Primary Lung Cancer
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崔大漢/Choi, D.H.
成樂振/吳尙伯/柳會性/Sung, N.J/Oh, S.B./Yoo, H.S.
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Abstract
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The frequency of primary lung cancer is increasing year by year, and is one of the main problems in modern medicine. Since the start of N.M.C. 8 years ago, 100 cases of primary lung cancer proved by histopathologic examination have been studied.
Thirty-four patients were completely followed-up after discharge.
Seventy-eight were males, 22 females. The majority of the patients were from 65 to 46 years of age, the youngest being 34 and the oldest 72.
The duration of symptoms before admission was in 45 cases of 1 to 6 months, in 37 cases 7 to 12 months, and in the remaining more than 12 months. The smoking history revealed that 41 patients had smoked for more than 20 years, 15 for less than 20 years, and that only six patients were non-smokers.
Histopathologically, 57 cases were of the squamous-cell type, 24 were anaplastic carcinomas, 11 adenocarcinomas and 8 tumors were not possible to classify. Thirty-six cases were primarily operable; 28 were subjected to pneumonectomy and 8 to lobectomy. The remaining 64 were non-resectable cases, but exploratory thoracotomy was performed in 7 of these patients.
Among the 36 resected cases, 13 were radically operated with one postoperative death, 8 were sudjected to palliative operative treatment with two postoperative deaths.
Seven had an extended operation performed (resection of lung combined with removal of chest wall; one death). Eight operated cases with 3 deaths were difficult to classify as either radical or palliative but were probably of the latter type, so the postoperative deaths totalled 7 in the first 30 postoperative days. The causes of death were mainly aspiration pneumonia, bleeding, sudden cardiac arrest or respiratory insufficiency.
Seven of all patients were treated with irradiation or chemotherapy.
Among the 34 followed-up cases, 21 had not been operated on and 19 died within 6 months and 2 surviving for 13 months.
Among 13 of the resected cases, 4(31 %) survived for more than 311 years ; the longest time being 6.9 years.
Three patients are still alive. We analysed these four cases, and found that all were of epidermoid type, without hilar lymphnode metastases, and the lesion was in every case confined to the lung itself.
Among 7 patients on whom the extended operation had been performed, two survived for nearly 2 years. When compared with the non-operation group, it is possible to prolong the survival time with extended surgery.
A long-term survival after lung cancer surgery may only be expected in those early epidermoid tumors confined to the lung itself, and without regional or other metastases.
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