Surgical Treatment of Primary Lung Cancer

원발성 폐암의 외과적 치료

The authors evaluated 200 cases of primary carcinoma of lung in terms of the cell type, operability, resectability and survival rate, that proved by histopathologic examination at the Dept. of Thoracic and Cardiovascular Surgery, Catholic Medical College during the period of 11 years from Jan., 1977 to Dec., 1987. The results are as follows; 1] The peak incidence was observed in the 7th decade of life [34%] and followed by 6th [30%] 8 5th decade [25%]. Male to female ratio was 3.4:1. 2] Histopathologic classifications were squamous cell carcinoma 48% [96 cases], adenocarcinoma 27% [34 cases], small cell carcinoma 13%[26 cases], ;bronchioloalveolar cell carcinoma 5% [10 cases], large cell carcinoma 4.5% [9 cases], adenosquamous cell carcinoma 1.5% [3 cases] and adenoalveolar cell carcinoma 0.5% [1 case]. 3] Among 200 cases of primary lung cancer, the operability was 47.5% [95 cases], refusal of operation 6.0% [12 cases] and inoperability 46.5% [93 cases]. 4] Ninety five cases [47.5%] were operated. Of these, post-surgical stage I was 18.9% [18 cases], stage II 24.2% [23 cases] and stage III 56.8% [54 cases]. Among 54 cases of stage III, 32 cases were unresectable, while 22 cases were resectable. Consequently, the resectability was 31.5% [63 cases] from the total numbers of 200 cases, and the resectability for the operable 95 cases was 66.3% [63 cases]. 5] Surgical complications were empyema with bronchopleural fistula [4 cases], G-I bleeding [1 case], tedious pleural effusion [1 case] and acute respiratory insufficiency [1 case]. Operative mortality was 3.2% [2 cases], which caused by massive G-I bleeding [1 case] and respiratory insufficiency [1 case]. 6] On the long term follow-up of resectable 63 cases, overall 3 year survival rate was 35%, 5 year 22% and 9 year 2%. Five year survival rate was 39% in stage l, 30% in stage II and 0% in stage III. As for the cell types, the higher 5 year survival rate was observed in resectable squamous cell carcinoma [35%] as compared to adenocarcinoma [15%], alveolar cell carcinoma [14%], small cell carcinoma [0%] and large cell carcinoma [0%].