[Long-term survival of patients operated on for primary bronchial cancers (excluding anaplastic cancers)]

The results of a retrospective study of patients operated upon for primary bronchial carcinoma (small-cell type excluded) are reported. The survival rates of 1285 patients who underwent tumoral excision between 1960 and 1973 were calculated by the actuarial method after exclusion of post-operative deaths. The overall survivals at 5 years' intervals were 31%, 18%, 11% and 8%. The excess mortality due to cancer was significant up to 15 years. Among 159 patients who survived for more than 10 years, relapses or new growths, sometimes amenable to surgical treatment, were relatively common. The cardiorespiratory status, living conditions and social rehabilitation of 149 patients who survived for more than 5 years showed good adaptation in most cases. The long-term prognosis was unrelated to age, sex or side of the tumour. The influence of the histological type depended on differentiation. Among surgical operations, lobectomy had the best prognosis. In patients who had simple pneumonectomy there was no significant difference between pneumonectomies performed on account of tumour of the main bronchus and the others. The place of enlarged pneumonectomy is defined. Of paramount importance for survival are the T.N.M. classification (UICC coding modified by Renault in 1975) and Carr's grading into 3 stages of increasing severity, notably the size and site of the tumour (T1 to T3) and the presence of pedicular or mediastinal lymph node involvement (N1-N2-N3). Early diagnosis is essential. Prospective studies involving several parameters (especially treatments combined with surgery) appear to be needed.