[Medical and surgical treatment of 209 bronchial cancers]

Of 209 unselected patients treated for bronchial carcinoma between 1976 and 1980, only 67 underwent surgery: 34 lobectomy (1 death), 19 pneumonectomy (5 deaths) and 14 exploratory thoracotomy without fatal outcome. Average survival time in lobectomy patients who died during the control period was 10 months and in those still alive 19.8 months. The corresponding figures for pneumonectomy patients were 3.9 and 17 months. Out of 142 patients considered unfit for surgery, 125 died. In the group who did not undergo radiotherapy, average survival time was 2.9 to 6.8 months depending on the histologic cell type of the carcinoma. In patients undergoing irradiation the corresponding figures were 4.7 and 7.0 months. In conclusion, radiotherapy was only of limited value in non-operated patients. Diagnosis of bronchial carcinoma is still established far too late, and therefore surgery in an unselected patient group was performed only in 32%. Lobectomy, if practicable, should be advocated as treatment of choice, whereas pneumonectomy, especially of the right side, involves marked operative mortality, provides results scarcely better than conservative treatment, and is recommended only in selected cases.