INCOMPLETE RESECTION OF LUNG-CANCER - MOR BIDITY AND PROGNOSIS

Residual tumor (R1) was proven at the proximal bronchial resection mar gin in 88 (3.6%) of 2464 cases of lung cancer following lung resection and standard lymph node dissection. Postoperative complications (8%) were: fistula of the bronchial suture line (n = 7), bleeding (n = 2) a nd heart luxation (n = 1). The in-hospital mortality was 16.6%. Causes of death were: bronchial fistula (n = 7), erosion of the pulmonary ar tery (n = 4), respiratory failure (n = 1), and empyema (n = 1). Forty- three patients received postoperative radiation therapy. Median surviv al of all patients following incomplete resection was 16 months, compa red to 37 months following complete resection (P < 0.001). Length of s urvival was independent of tumor stage, histology, site of infiltratio n and postoperative radiation. In conclusion, in resection for lung ca ncer clear margins should be verified by intraoperative frozen section . In the case of residual tumor at the bronchial resection margin, wid er resection is mandatory in stage I and II if the patient meets the f unctional criteria. Even in stage IIIa and IIIb prognosis is significa ntly better after complete resection than R1-resection; the difference , however, is smaller than in lower stages.