[Palliative pulmonary resection for primary lung cancer]

From January 1961 through December 1984, 253 of 2048 patients who have undergone surgical treatment for primary lung cancer were retreated by palliative pulmonary resection. The indications of palliative resection were: there was partial carcinoma or metastatic lymph node left in the thorax; microscopically, residual tumor was found on bronchial stump margin. Operation modes: partial pulmonary resection 135, total pneumonectomy 118. Postoperative complications occurred in 25 cases and 17 died in the hospital with in 30 days. 236 cases were followed-up for 1 to 21 years. The 1-year, 3-year and 5-year survival rates after operation were 51.3%, 13.1% and 8.1% respectively. The survival rates after palliative pulmonary resection for squamous and adenocarcinoma were higher than thoracotomy but the survival rates of large undifferentiated, small cell and mixed cancer were similar to those of thoracotomy. Besides, patients who had both subcarinal lymph node involvement and incomplete excision in resection had the worst prognosis. The authors consider that squamous and adeno carcinoma of the lung are the main indication for palliative resection. Subcarinal lymph nodes must be excised as much as possible while operation, otherwise local radiation and/or chemotherapy should be performed after operation.