Squamous cell carcinoma of the lung: prognostic factors affecting the long-term outcome after surgical resection

From 1976 to 1989, 638 patients with squamous cell carcinoma were operated on. Reliable information concerning survival could be obtained in 540 of these cases via follow-up examinations. All tumors were retrospectively classified according to the TNM system of the fourth edition of UICC classification. The average survival time after potentially curative operation was 7.32 years in patients with stage I tumors, the 5-year survival rate was 55.3%. The corresponding values were 2.42 years and 29.1% respectively in patients with stage II tumors, compared to 1.22 years and 12.0% respectively in those with stage III a tumors. The differences between tumor stages are statistically significant. Analyzing the influence of the T and N factors on the prognosis following potentially curative surgery, the classification in the various tumor stages was largely verified. Stage III a is inhomogeneous in terms of prognosis. T and N factors showed prognostic value in this group. In the group with T3 tumors there was a significant difference in the mean survival times, independently of the lymph node status, when the patients were divided into those with T3 tumors close to the main carina (16 months) and those who had infiltrated adjacent structures (7.5 months). When differentiating the N1 location, a significant difference was found between the group of patients with T2 tumors and true lymph node metastases and the group with T2 and direct tumor infiltration of the lymph node (mean survival time 27.5 vs 42.3 months).(ABSTRACT TRUNCATED AT 250 WORDS)