[Early peripheral cancer of the lung: long-term results of combined therapy using sparing resection techniques]

Abstract

Two hundred-thirty patients were operated on for peripheral lung cancer TIN0M0 in 1960-1990. Pheumonectory was performed in 3 cases, lobectomy-123, segmentectomy-40, wedge-like resection-57 and removal of tumor-in 7 cases. Limited resection in 20 patients was not followed by radiation therapy, Radiation treatment was given to 15 patients preoperatively, 53-postoperatively and 16 patients-pre-and postoperatively, Five-year survival after combined treatment was recorded in 70.5%, while without this treatment-68.7%. Local recurrences following limited intervention were usually detected 3-5 years later, regional and distant metastases developing within the first 24 months. A reverse correlation was established between extent of surgery and local recurrence incidence. Reoperation such as lobectomy or pneumonectomy is feasible in cases of timely diagnosis. The highest 5-year survival rates were registered for segmentectomies carried out in combination with postoperative radiotherapy (77.2%). Prognosis proved best in cases of adenocarcinoma and tumor arising in the cicatrix. Paliative surgery appeared preferable for primary tumor 1.5 cm in diameter and less. Even in small-size malignancy, removal of tumor is not radical enough, Wedge-like resection is admissible in small-size subpleural lesions only. Preoperative radiotherapy results proved inferior to those of other procedures of combined treatment. Pronounced radiation-induced pneumonitis involving re-hospitalization for symptomatic treatment occurred in 7 (5.5%) cases of lobectomy combined with radiotherapy and in 2 (1.9%) cases of limited resection.