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KMID : 0371319690110010047
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Journal of the Korean Surgical Society
1969 Volume.11 No. 1 p.47 ~ p.53
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Malignant Tumor of the Lung
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李泰權/Lee, T.K.
李根泳/丁乙三/蘇文錫/Seel, D.J./Lee, K.Y./Chung, E.S./Soh, E.S./--
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Abstract
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During the period of 5 years from April 1963 to March 1968 one hundred and thirty-six cases of lung cancer were seen at Presbyterian Medical Center, in Chonju, Korea. Among these 136 patients,106 patients were proven to have a malignant tumor of the lung histologically. This report is based on those 106 cases.
1. Sex incidence showed male predominace, the ratio being 7.1 : 1. The age ranged from 20 to 73, the mean age was 53.9 years, and the peak incidence was observed in the 5th decade of life.
2. The major symptoms were cough, sputum, dyspnea, chest pain, and hemoptysis, in that order of frequency.
3. The ratio between cigarette smokers and non-smokers was 7.5 : 1 among the 85 patients on whom this information was available. (Twenty one patients were indeterminate.)
4. Bronchoscopy was performed on 57 cases and positive biopsy was obtained in 38 cases (66.6%). Some patients already had distant metastasis at the time of first examination and bronchoscopy was therefore omitted.
5. Cytology of bronchial washings was done in 36 cases and was positive (classⅢ-Ⅴ) in 24 cases (66.6%).
6. Distant metastasis was persent in 46 patients at first cxamination. The sites were the cervical nodes in 36 cases, axillary nodes in 5 cases, bone in 10 cases, subcutanous tissue in 3 cases. Some had more than two sites of distant metastasis.
7. The outstanding findings on chest X-ray films were the following: mass shadow 58 cases; atelectasis, 37 cases; pleural effusion, 20 cases; pneumonitis 14 cases; abscess 6 cases; findings of concommitant tuberculosis, 6 cases; and erosion of the ribs, 3 cases.
8. The pthological classification was as follows: epidermoid carcinoma, 40 cases (37.7%) : Anaplastic carcinoma (including oat cell carcinoma, round cell carcinoma), 60 cases (56.6%) adenocarcinoma, 3 cases ( 2.8%) : alveolar cell carcinoma, 2 cases (1.8%) : leiomyosarcoma, 1 case (0.9%)
9. The data in regard to treatment and survival are as follows: In 19 cases (17.9%) thoracotomy was performed, and 13 patients (68.4 of those operated on) had resection with curative intent.
One patient died of right pneumonectomy (operative mortality 7.6%), of the remaining 12 cases who sruvived resection, 8 patients died of cancer, their survial time ranging from 2 to 36 months. Four patients are living without evidence of disease at the present time, the period of survival ranging from 8 to 24 months. Palliative radiation therapy was given to 14 patients, all of whom have died of cancer. Their mean survival time was 6.2 months. Combined radiation therapy and nitrogen mustard were given to 7 patients, all of whom are dead of cancer, their mean survival time being 2.8 months. Six cases received nitrogen mustard only; their mean survival time was 2 months. Sixty-six patients were untreated and 50 of those are known dead and their average survival time was 1.9 months. The rest, 16 cases, were lost to follow-up and are presumed to be dead.
The operability rate of 17.9% is unfortunately low, but represents not only the relatively high incidence of advanced disease but also the fact that many patients refused thoracotomy out of fear, destitution, or ignorance.
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