[Surgical treatment of T4 primary lung cancer]

We investigated 257 T4 primary lung cancer patients who received operation in 30 hospitals of a lung cancer surgical therapy group of Chubu and present the results of questionnaires on the outcomes of surgical treatment for the T4 cases. T4 cases were classified as follows; 147 resections (57.4%); 110 exploratory thoracotomies (42.8%) ; 90 pleural dissemination and pleural effusions; 33 aorta; 30 left atrium and 17 superior vena cava. Survival rate of the T4 lung cancer patients in resection group and exploratory thoracotomy group were respectively 49.1% and 37.8% for one-year survival rate, and 15.1% and 4.7% for three-year survival rate. P of these two groups was 0.06 from Logrank test. Thirty three patients (21 resection and 12 exploratory thoracotomies) survived for two years and more. The number of cases by invasive organ was 17 pleural disseminations and effusion, 4 aorta, 4 left atrium and 3 mediastinum. We questionnaire on surgical operation for T4 cases with poor prognosis and obtained the result that half of the hospitals were positively performing surgery and the other half revealed a policy avoiding surgery.