[Extended resection for lung cancer]

Of the 740 patients with primary lung cancer operated on at our department between January, 1982 and December, 1991, 108 (14.6%) underwent extended operation involving combined resection of adjacent organs. The 5-year survival rates in patients who underwent resection of the parietal pleura (n = 62), thoracic wall (n = 25), diaphragm (n = 11), left atrium (n = 7), superior vena cava (n = 6), and aorta (n = 5) were 13.8%, 20.5%, 14.9%, 0%, 51.4%, 0%, and 20.0%, respectively. Surgical treatment for stage III advanced lung cancer is controversial, but the 5-year survival rates in those who underwent combined resection of the parietal pleura, thoracic wall including the ribs, left atrium, and aorta were not lower than that in all patients with stage III lung cancer. Especially, long-term survivals of 5 years and 11 months and 10 years and 6 months were obtained in patients who underwent resection of the left atrium, and 6-year survival was observed in a patient who underwent resection of the aorta, suggesting that extended resection is effective in some cases. The outcome of combined resection of the diaphragm and the superior vena cava was poor, with no patients surviving for 5 years.