SURGICAL RESULTS AND PROGNOSTIC FACTORS IN EARLY NONSMALL CELL LUNG-CANCER

Background. We attempted to clarify the prognostic value of tumor size (maximum, 3 cm), the evidence of invasion proximal to a lobar bronchu s at least 2 cm distal to the carina, and the absence or presence of v isceral pleura invasion in patients with completely resected non-small cell lung carcinoma without lymph node invasion or satellite lesions (T1 N0 M0, T2 N0 M0). Methods. The study included 158 patients. Foul p atients were excluded due to postoperative mortality (2.5%). The varia bles selected for the survival study were sex, age, symptoms presence or absence, bronchial invasion level (evidence or not of invasion prox imal to a lobar bronchus at least 2 cm distal to the carina), pulmonar y location, pneumonectomy or lesser resection, cell type, squamous or nonsquamous, tumor size, invasion or not of the visceral pleura, and T 1 or T2 status. Results. The overall survival rate in this series was 74% at 5 years and 60% at 10 years. Only the tumor size had a signific ant influence on survival (p = 0.0092). Patients with a tumor less tha n 2 cm in diameter did better (p = 0.0023). Conclusions. These observa tions suggest that it will be necessary to further research in clarify ing the prognostic value of the bronchial. invasion level and of the d egree of the visceral pleura invasion and its implications when classi fying a tumor as T1 or T2. (C) 1997 by The Society of Thoracic Surgeon s.