LUNG-CANCER IN WEST SWEDEN 1976-1985 - A STUDY OF TRENDS AND SURVIVALWITH SPECIAL REFERENCE TO SURGICAL-TREATMENT

We reviewed 3285 consecutive cases of lung cancer diagnosed in West Sw eden during the period 1976-1985, Data were collected from the regiona l cancer registry, the Swedish National Population Registry, and medic al records, During the study period, the annual female/male ratio incr eased from 0.29 to 0.42, In females, there was an increase primarily i n the incidence of tobacco-related morphologic tumour types (i.e. squa mous and small cell lung cancers), In males, a moderate increase of ad enocarcinomas was seen, although squamous cell cancer remained the mos t common tumour type, The overall 5-year survival rate was 8.3%. In 64 1 patients (20%) a surgical tumour resection was carried out, The 5-ye ar survival rate following resection was 38%, and the probability of 1 0-year survival was estimated at 25%, In a multifactorial model includ ing gender, age, histology, pTNM stage and extent of resection, pTNM s tage and, to a lesser degree, age were statistically significant indep endent predictors of postoperative survival, The five-year survival wa s 57% in stage I, 21-27% in stage II and IIIa, and 10% in stage IIIb, Of all resected patients, 4.2% died within two months after resection, In males, early postoperative mortality was predicted by preoperative bicycle ergometry, The prognosis in non-resected patients was poor, w ith only 2% surviving 5 years or longer, In conclusion, the results in dicate that some progress has been made with regard to surgical manage ment of lung cancer, but they also point to the fact that the vast maj ority of patients are not amenable to curative treatments, and that th e overall survival in lung cancer has improved only marginally during the last decades.