[Surgical treatment of 48 primary peripheral, non-small cell lung cancers equal to or greater than 8 cm. Prognostic factors and 5 years' survival]

Abstract

In a series of 885 resections for lung carcinoma performed between 1976 and 1986, 48 (5.5%) were for large size tumors of 8 cm and over. Pneumonectomy was performed in 28 patients (58.3%), lobectomy in 17 (35.5%) and bilobectomy in 3 (6.2). Histological type of tumor was squamous cell in 27, adenocarcinoma in 9, large cell carcinoma in 10, and adenosquamous carcinoma in 2. The stage of the disease was stage I in 16 cases, stage II in 3 cases, and stage III in 29 cases. Total survival rate including perioperative mortality (3 deaths) was 30.5% at 3 years and 16.3% at 5 years. The best prognostic factors are: age under 60 (23% survival at 5 years, and no survival over 60, (p = 0.01), absence of weight loss (24% survival at 3 years, and 14% at 3 years in case of weight loss (p = 0.02), absence of symptoms (44% at 3 years) but no survival in case of symptoms (p = 0.02), no invasion of mediastinal lymph nodes (N0 and N1), and stage I and II of the disease (50% of survival at 3 years against 20% for stage III (p = 0.04). There was no relation to survival rate between T2 and T3, squamous and adenocarcinoma, and between lobectomy and pneumonectomy. Most of our patients died of post-operative metastasis (52%), related to the large size of the tumor.