[Histology and prognosis in lung cancer treatment]

In 678 cases of surgically resected lung cancer, morphological factors influencing prognosis were evaluated, especially in adenocarcinomas (283 cases) and squamous cell carcinomas (270 cases). In adenocarcinoma cases, sex, degree of differentiation, classification by cell type, lymphatic invasion, vascular invasion, pleural involvement, intrapulmonary metastasis, grade of scarring associated with a tumor, atypia of cells and mitotic index were significantly evaluated. The scoring of these factors will contribute to the clinician's decisions on the necessity and selection of post-adjuvant chemotherapy, especially even in Stage I. In squamous cell carcinoma cases, location of tumor, tumor size, lymphatic invasion, vascular invasion and pleural involvement were also significantly evaluated. In 160 patients treated by chemotherapy involving cisplatin, chemotherapeutic response in squamous cell carcinoma (39 cases) was more effective and survived longer these than in adenocarcinoma (107 cases) and large cell carcinoma (14 cases). In 233 non-small cell lung cancer patients treated by chemotherapy, there were 33 cases of long-term survival more than 2 years; that is, 8 cases (3.4%) disease-free and 25 cases (10.7%) alive with cancer. The group which remained disease-free for over 2 years, consisted only of patients with Stage IIIa or IIIb, and PR was achieved with chemotherapy and radiation. Among patients who lived over 2 years, many squamous cell carcinoma cases (5/6) remained disease-free. On the other hand, adenocarcinoma was less responsive to chemotherapy and almost all cases (24/27) were alive with cancer. The relationship between the effectiveness of chemotherapy and prognosis among histological subtypes was examined in small cell lung cancer.(ABSTRACT TRUNCATED AT 250 WORDS)