RESULTS OF RESECTION OF T3 NONSMALL CELL LUNG-CANCER INVADING THE MEDIASTINUM OR MAIN BRONCHUS

Background. T3 tumors can be divided into several subgroups. Surgical treatment of T3 tumors with chest wall invasion results in good surviv al. This study shows the results of resection of T3 non-small cell tum ors located in the main bronchus or with invasion of mediastinal struc tures. Methods. From 1977 through 1993, 108 patients underwent resecti on for primary non-small cell carcinomas located in the main bronchus or with invasion of mediastinal structures. A complete resection was p erformed in 70 patients (64.8%). Actuarial survival time was estimated and risk factors for late death were identified. Results. Overall hos pital mortality ws 8.3%. All death followed pneumonectomy. Mean 5-year survival was 29% for all hospital survivors, 355 for patients with co mplete resection, and 18% for patients with incomplete resection (p=0. 03). In patients with complete resection, mean 5-year survival was 45% for N0 patients and 37% for N1 patients. There were no 5-year survivo rs in the group of N2 patients. The mean 5-year survival was greater ( but not statistically significantly greater) in patients with tumors l ocated in the main bronchus (40% than in patients with tumors with inv asion of mediastinal structures (25%) (p>0.05). Histology, tumor spill , age, sex, and type of operative procedure were not significant progn ostic factors. Conclusions. Patients with tumors located in the main b ronchus have a better survival than patients with invasion of the medi astinal structures. Pheumonectomy increases hospital mortality. Incomp leteness of resection and mediastinal lymph node involvement influence survival significantly.