[Surgical therapeutic planning for non-small cell lung cancer]

The survival rates of 380 resected cases of lung cancer in our hospital were analyzed according to curability and histological cell type. The overall 5-year survival rate for stage I a cases was 64.5%, that for stage I b 52.3%, and that for stage II 26.7%. However, there were distinct differences in survival rates between stages I a-II with mediastinal lymph node dissection and those without mediastinal lymph node dissection. Of these 380 tumors, many were advanced (for instance, stage III tumors comprised 180 cases). T3 tumors had better prognosis (40.7% showing 5-year survival) than N2 tumors (26.7% showing 5-year survival). Among stage III tumors, squamous cell carcinoma (T3: 41%, N2: 36.7% showing 5-year survival) had a better prognosis than adenocarcinoma (T3: 16.1%, N2: 21.4%). T3N2 tumors, however, had such a poor prognosis that the value of surgery in these cases seemed questionable. Adjuvant therapy should therefore be evaluated accurately in future to improve prognosis. It was stressed that a randomized controlled study would be needed to evaluate the effectiveness of adjuvant therapy.