[Evaluation of lung cancer treatment in an unselected population]

The modality of lung cancer treatment was retrospectively evaluated in an unselected population. All the lung cancer cases diagnosed among the residents in a Local Sanitary Unit of Lombardy during four years (1974-1979), were identified. The clinical records of the 235 collected patients were reviewed and on this basis the anatomical extent of disease was retrospectively classified in stages according to the TNM of UICC (1978). The relative frequency of clinical stages resulted 29% for stage I, 17% II, 20% III and 32% IV. Only 57% of all the subjects had been treated; 11% by resection, 22% by radiotherapy and 24% by chemotherapy. For the stages I and II the operability rates were 35% and 26% respectively, while the resectability rates were 29% and 17%. An objective reason of exclusion from surgery was found in no more than a quarter of stage I and II lung cancers, while the remaining (40%) had probably been excluded from exploration owing to a subjective prognostic evaluation. If compared with similar reports from other countries, these data show a striking defect in the choice of curative treatment for a high proportion of the examined cases.