J.Jpn. Surg. Soc.. 83(9): 967-970, 1982
Report on the annual meeting
SURGICAL INDICATION IN LOCALLY ADVANCED LUNG CANCER: A HISTOLOGIC CONSIDERATION
|
Dept. Surgery, National Cancer Center, Tokyo, Japan Takeshi Yoneyama |
In cases in which the mediastinal lymphnode was involved, tumor reductive surgery did not alter the natural course of disease regardless of the histology. Long-term survivors were achieved only among those who had relative curative resection of well differentiated squamous cell carcinoma. Relative curative surgery in well differentiated adenocarcinoma produced the median survival time of 24 months which is over that of patients who had chemotherapy alone.
Among the cases in which the tumor has grossly extended beyond the lung, none of the cases with invasion of intercostal muscle or ribs, or with mediastinal nodal involvement survived more than two years even when wide resection and adjuvant irradiation therapy were done. Expectation of long-term survival was limited in relative curative surgery of well differentiated squamous cell carcinoma whose extrapulmonary node was negative for cancer. In the case of adenocarcinoma, incidence of T3N2 patients was 61.0% which was higher than the 36.1% of squamous cell carcinoma. Advantage in the median survival was achieved in relative curative resection of well differentiated adenocarcinoma whose extrapulmonary node was negative.
In order to reduce the incidence of needless or unnecessary extensive surgery,it is advocated that rigorous pre-operative assessment of individual tumor characteristics and precise definition of extrapulmonary invasion are made. More sophisticated evaluation of patient's performance status is also of critical importance.
To read the PDF file you will need Adobe Reader installed on your computer.