[Surgical position and possibilities in bronchial carcinoma]

In accordance with international statistics 25% of all patients with bronchogenic carcinoma can be treated by resection at the moment the diagnosis is established. The 5 year survival rate is in most series 25%. Important prognostic factors are: TNM-stage, histological classification, biological nature of the tumour and involvement of lymph nodes; discussed are further localisation of the primary tumour and immunological status. The summarizing statistics show that the carcinoma of squamous cell type has the best chance of a 5 year survival with a rate of more than 50%. In small-cell carcinoma extremely different 5 year survival rates between 0 and 20% are reported. In the surgical treatment it is obvious that the number of lobectomies are increasing in comparison to pneumonectomies. The postoperative mortality rate differs for "radical" pneumonectomy between 20% and 35%, for simple pneumonectomy between 7% and 10% and for lobectomy below 2%. Determinant for the postoperative course is the preoperative estimation of the risk factors. The 5 year survival rate after broncho- or angioplastic procedures varies in different series between 9,8% and 36%. In segmentectomies and wedge resections the 5 year survival rate was up to 56%. Primary palliative resections are indicated for pain reduction and improvement of the quality of life.