SHORT-TERM SURVIVAL AFTER MAJOR PULMONARY RESECTIONS FOR BRONCHOGENIC-CARCINOMA

From January 27, 1992 to December 12, 1994, 100 consecutive patients ( 86 men and 14 women) with a mean age of 62.5 years underwent lung rese ction for a non-small cell lung cancer. Squamous cell carcinoma was pr edominantly found (52%), followed by adenocarcinoma (23%) and large ce ll carcinoma (18%). Postoperative staging was Stage 0, 1 patient; Stag e I, 57; Stage II, 17; Stage IIIa, 20 and Stage IIIb, 5. Thirty-day mo rtality was 4% (4 patients) with 10.7% for pneumonectomy and 0% for lo bectomy or lesser resection. For the whole group 1-, 2- and 3-year sur vival rates were 83%, 68% and 65% respectively. Survival rates for NO, N1 and N2 after 3 years were 70%, 59% and 54% respectively. In the un ivariate analysis, a trend to statistical significance was noted betwe en NO and N1 (p=0.08). There was no difference in short-term survival between NO and N2 which represents a highly selected group of patients with N2 disease. In the multivariate analysis the only two independen t variables with impact on survival were number of pack-years and diam eter of the tumour (p <0.05). Ninety-two quality of life questionnaire s (EORTC QLQ-C30) were sent to home physicians. We collected 31 questi onnaires (34%) after 2.5 months. A clear relationship was not seen bet ween complaints of pain or dyspnea and extent of resection or lung fun ction postoperatively. Instead, the global quality of life seemed to b e influenced by the extent of resection to the advantage of a lobectom y and disadvantage of a pneumonectomy. Difficulties related to quality of life analysis are discussed and future directions are given.