Survival after surgical treatment of lung cancer

All 205 patients operated on for primary pulmonary cancer at Oulu University Hospital in 1975-1977 were followed up for 10 years to evaluate the prognostic influence of factors such as lymph-node invasion, size of tumour and histologic type. Preoperative mediastinoscopy was performed on 186 patients (91.2%), and revealed no mediastinal metastases in 182. Nevertheless N 2 (mediastinal) lymph nodes were found in 36 cases at operation and N 1 (perihilar or ipsilateral) nodes in 42. Despite lobectomy or pneumonectomy, all 32 patients (17.2%) with false-negative mediastinoscopy died within a year (mean 7.2 months) of operation. Pneumonectomy was performed in 67 cases (29 right, 38 left), lobectomy or bilobectomy in 125 and exploratory thoracotomy in the remainder. Most of the tumours were epidermoid carcinoma (53.7%). Adenocarcinoma was present in 20%, and large-cell carcinoma and oat-cell carcinoma each in 11.7%. Survival rates were significantly higher in patients without vs. those with lymph-node metastases and in epidermoid or adenocarcinoma vs. small-cell carcinoma.