Changes in outcome for patients with bronchial carcinoma: the Green Lane Hospital experience

To evaluate the effect of changes in the management of bronchial carcinoma at Green Lane Hospital, we have made a retrospective analysis of patients presenting in 1978 and 1979. Previous reviews from this unit provided a comparison. There was a modest improvement in the 5-year survival for the group as a whole (4.3% in 1955-65 to 7.7% in 1978-79). For patients undergoing surgical resection, the improvement in 5-year survival from 22% to 40.5% appeared mainly due to better pre-operative selection. Patients with non-small-cell carcinoma selected for radical radiotherapy had a 5-year survival of 7.2%. During the study period, radiotherapy alone was replaced by a combination of chemotherapy and radiotherapy for limited small-cell carcinoma. Median survival improved from six months to 13.5 months and was better than the 7.5 months obtained with surgical resection in 1955-65. Twenty-four patients were referred as a result of mass miniature x-ray (MMR) at a rate of 22/100 000 radiographs taken. Five-year survival for the MMR group was statistically better than for the rest of the group (29% compared to 7.2%; p less than 0.001), supporting the practice of x-raying smokers over the age of 45 annually.