A CLINICAL ANALYSIS OF SMALL-SIZED LUNG-CANCER WITH ADVANCED DISEASE

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.