Postresection stage grouping in carcinoma of the lung

The postsurgical treatment classification and staging system for carcinoma of the lung has been evaluated in a series of 403 patients admitted to a completed prospective randomized adjuvant cancer chemotherapy trial conducted by the Veterans Administration Surgical Adjuvant Group. The proposed T, N and M classification suggested by the American Joint Committee for Cancer Staging and End Results Reporting is supported. However, the stage groupings as suggested by the Committee fails to separate adequately the various prognostic groups. This appears to be better accomplished by the stage grouping modification suggested by the Radiation Therapy Oncology Group. In the latter schema, the five year survival rate of patients with postsurgical treatment Stage I disease is 40.9 per cent; Stage II, 26.2 per cent, and Stage III, 10.5 per cent. In the Joint Committee classification, these survival rates are 30.8 per cent, 25.5 per cent and 10.5 per cent, respectively. In addition, 18 patients with undifferentiated small cell carcinoma were also evaluated. The long term survival of three of sixe patients with small peripheral lesions without metastatic lymph node involvement supports the opinion that resection of these specific lesions continues to be the treatment of choice.