J. Shimizu et al., A CLINICAL ANALYSIS OF SMALL-SIZED LUNG-CANCER WITH ADVANCED DISEASE, SURGERY TODAY-THE JAPANESE JOURNAL OF SURGERY, 24(1), 1994, pp. 19-23
A clinical analysis of small-sized lung cancers with advanced disease
was conducted on a total of 58 patients: 34 diagnosed as T1N2, 6 as T1
N3, 9 as T1M1, and 9 as T4 due to pleural dissemination. The cumulativ
e 5-year survival rate after surgery for the 34 patients with a T1N2 l
esion was 17.4%. Of these 34 patients, 24 underwent a curative operati
on resulting in a 5-year survival rate of 23.7%, but the remaining 10
patients, who underwent a non-curative operation, had a 5-year surviva
l rate of 0%. Extended lymph node dissection for N3 disease has only b
een performed in recent years, so it is not yet clear whether it will
affect the survival rate or not. T4 disease due to pleural disseminati
on and T1M1 disease associated with intrapulmonary metastasis encounte
red at thoracotomy could be expected to have relatively long-term surv
ival with the combined use of systemic immunochemotherapy after surger
y. In cases diagnosed as r4 due to pleural dissemination, we have rece
ntly employed resection of the primary lesion with parietal pleurectom
y as the standard operative procedure. For cases of T1M1 with intrapul
monary metastasis confined to the same lobe as the primary lesion, a l
obectomy is usually performed, while for cases with intrapulmonary met
astasis extending to another lobe, a lobectomy with enucleation of met
astatic nodules or pneumonectomy is most often performed instead of an
exploratory thoracotomy.