ADENOCARCINOMA OF THE LUNG - CLINICAL-FEATURES AND SURVIVAL

Four thousand patients were registered by the Edinburgh Lung Cancer Gr oup in 1981-1987; 9.5% had adenocarcinoma. Of these, 102 patients with pathological confirmation of the diagnosis, presenting to one hospita l group in Edinburgh, were reviewed. Two cases were excluded after cas e note review. Of the remaining 100, 64 were male and 36 were female, with a mean age of 73 years. The majority (89%) were smokers or ex-smo kers, and 52% had a poor performance status (Karnofsky Index 10-70). S ignificantly, more adenocarcinoma patients underwent surgery compared to other cell types (39 vs. 19%, P<0.01), and less were treated with r adiotherapy (19 vs. 31%). The 5-yr survival rate for the adenocarcinom a patients was 19 vs. 7% in the remainder of patients. Of 39 patients referred for surgery, 37 had lung resections and their 5-yr survival r ate was 42%. Post-operative staging showed 48% in Stage I, 27% in Stag e II and 24% in Stage III. The majority of the long-term survivors had Stage I disease (64%). Forty-two percent of the patients received pal liative therapy alone (all died within ID months). Ten percent of pati ents receiving radiotherapy survived for 5 yr. Review of these cases s uggested two patterns of presentations: (1) patients with poor perform ance status, extensive disease and often pleural involvement (16%); an d (2) patients with more localized disease (39%), many of whom were su itable for surgical resection with surprisingly good prognosis.