Surgery for T4 lung cancer: the prognoses of T4 lung cancer

The prognoses of T4 lung cancer patients treated surgically were investigated in 76 patients. Extended resection was performed in 21 patients, palliative resection in 21 and exploratory thoracotomy in 34. Although the five-year survival of the extended resection group did not differ significantly from that obtained in the exploratory thoracotomy group, the mean survival time of the extended resection group was 3.1 months longer than that of the exploratory thoracotomy group. Two patients who had undergone resection for left atrial involvement, survived for two years or more, and a T4N0 patient with squamous cell carcinoma, in whom resection for aortic involvement was carried out, died from an unrelated disease after 15 months. Two patients with pleural dissemination, who underwent panpleuropneumonectomy, survived for two years. Surgical intervention did not improve the prognosis of patients with N2-squamous cell carcinoma, those with malignant effusion or those with multiple organ involvement.