RESULTS OF SURGICAL-TREATMENT OF STAGE IIIA NONSMALL CELL LUNG-CANCER

From 1975 to 1993, 665 patients with non-small cell lung carcinoma (NS CLC) were studied in our Unit. Of the 55 stage IIIA patients submitted to resection, 50 were followed-up in order to evaluate the effectiven ess of surgery and to identify which variables had a prognostic impact on survival. The expectancy of survival at 3,5 and 10 years was 31.7, 19.5 and 13.7%, respectively. When the analysis was limited to N2 pat ients, 3,5- and 10-year survival rates were 20.9, 14 and 7%, resepctiv ely. Regarding the ''TN'' factor, the T3NO subset presented the highes t expected survival (24.8 and 18.6% at 5 and 10 years). With regard to the ''T3'' factor and type of surgery, peripheral tumors submitted to en bloc resection of the chest wall showed the best 5-year survival r ate (42.9%), whereas extrapleural resections - even for tumors confine d to the parietal pleura - showed a 5-year survival rate of 14.3%. A s lightly higher risk of death was observed in tumors originating in the superior sulcus (SST). No patients with mediastinal pleura and perica rdium involvement survived more than 34 months. With univariate analys is, ''N2'' was the variable most significantly associated with a negat ive prognosis when related to T3 (T3N2 vs T3NO 0.025<P<0.05) or non-ep idermoid tumor (no survivors at 3 years; N2 epidermoid vs N2 non-epide rmoid tumor P<0.05). Applying multivariate analysis, epidermoid cell t ype, even if exclusively for N2 tumors, was an independent prognostic factor, showing a favorable impact on survival expectancy (27.8% at 90 months).