Survival in lung cancer after surgery

In 1053 patients hospitalized for primary lung cancer the overall crude survival rate (5 years) was 15.5%. Prognostically favourable indices were: absence of clinical symptoms (27% survival) and a peripheral site of tumour in the lung (28% survival). Duration of symptoms, when present, had no consistent influence on prognosis. Resection could be done in 419 cases. In this group the 5 years survival rate was strongly related to the extent of surgery and the completeness of resection. Cases with a radical lobectomy had a survival rate of 52% against 9% only in patients with a pneumonectomy that might not have been radical. Of 33 cases of resected small cell anaplastic cancer, 10 survived more than 5 years. This unexpectedly high survival rate persisted after revision of the histological typing and may justify an active surgical attitude even in this group of patients. Although hardly decisive in this context, confusion between the comprehensive term small cell carcinoma and its subtype, oat cell cancer, should be avoided.