Impact on survival of the extent of resection in unrelapsed lung cancer

Five-year survival of resected stage Ia non-oat cell lung cancer was evaluated in 69 consecutive patients without recurrence. The impact of the extent of resection on perioperative and long-term mortality was studied after an evaluation of confounding factors, such as age and associated cardiopulmonary diseases, which further stratified our series. Our patients were subdivided into 2 groups: the first included lobectomies and was further subdivided into 2 subsets according to whether the operation had caused the resection of less than 4 (30 cases) or more than 3 segments (18 cases). The second one included pneumonectomies (21 cases). Thirty-two patients were 60 years or older; pulmonary and/or cardiovascular diseases were assessed in 38 patients. There were 6 perioperative deaths, 3 among major lobectomies (more than 3 segments resected) and 3 among pneumonectomies. Survival rate of lobectomies was 75% (86% for minor, 55% for major lobectomies), and 57% for pneumonectomies. Major lobectomies included the highest percentage of elderly patients with cardiopulmonary diseases who had significantly poorer survival probabilities than young subjects without cardiopneumopathies. Lobectomy cases, after standardization by age, had a significantly higher probability of surviving than pneumonectomy cases. Standardization by cardiopulmonary disease showed a better chance for lobectomy cases, although it was not significant. Major lobectomy cases had poorer cumulative survival rate than minor lobectomy cases. Such a difference was revealed in patients 60 years or older and in those with pneumocardiopathies.