[Recurrence and survival after surgical treatment of lung cancer]

2500 new cases of lung cancer are diagnosed in Norway annually. Patients with limited disease can be operated, but many will die from the disease despite surgical treatment. The aim of the study was to review survival and recurrence, and factors which affect survival, in patients operated for lung cancer.

The risk of death and recurrence of disease was assessed retrospectively in patients who had non-small lung cancer and were operated at St. Olavs University Hospital, Trondheim in the period 1994-2001. Patient data were retrieved from medical records and a database with records from thoracosurgical procedures.

190 patients (30 % women) were included in the study. Average observation time after surgery was 58.3 months (range 21-99). Adenocarcinoma was the most common histological cancer type and occurred in 57.9 % of women and 39.1 % of the men (p = 0.02). The 30-day mortality rate was 3.2 % and the 60-day rate was 4.7 %. Recurrence of the disease was found in 45.8 %, among them median time to recurrence was 9 months after the operation. 5-year survival was 42 %, as analysed by the Kaplan-Meier estimate, and survival was best for early stages of the disease. 5-year survival was better for women (53.3 %) than men (36.8 %), p = 0.05. Prognostic factors for survival, estimated by Hazard ratio for death with Cox multiple regression analysis, were sex, age at the time of operation, type of operation, tumour diameter and postoperative N-stage.

Postoperative mortality and survival corresponded to data in the literature. Early stage lung cancer can be cured with surgical treatment. Our study confirms an increase in the incidence of adenocarcinoma among lung cancer patients during the last decades. Female sex is a positive prognostic factor for survival, as is young age, small tumor size, standard lobectomy, and absence of lymph node metastases.