PROGNOSIS OF IPSILATERAL INTRAPULMONARY METASTASES IN RESECTED NONSMALL CELL LUNG-CANCER

Objective: According to the new classification of intrapulmonary metas tasis (pm) of lung cancer by the American Joint Committee on Cancer (A JCC), ipsilateral pm is classified as a T factor. We evaluated the pro gnostic factors of ipsilateral pm after surgical treatment, and validi ty of the new classification. Methods: From January 1977 to December 1 994, 41 patients (24 males and 17 females) with lung cancer had a post operative diagnosis of intrapulmonary pm. The histologic type consiste d of 27 adenocarcinoma, 12 squamous cell carcinoma, and 1 large cell c arcinoma. Twenty patients had pm in the same lobe in which the primary lesion was located, and 21 patients had pm in ipsilateral different l obe(s). Thirty patients underwent lobectomy, 5 bilobectomy and 6 pneum onectomy. Survival was calculated by the Kaplan Meier method, and Cox proportional hazards model was used for multivariate analysis. Results : The overall survival was 25.8% at 5 years (median survival time (MST ), 26 months). The 3-year survival of patients with pm in the same lob e was 49% (MST, 33 months), and that of patients with different lobe w as 21% (MST, 16 months) (P = 0.237). There were no significant differe nces in survival in relation to age ses, histology. pathological N fac tor, or number of pm. Multivariate analysis identified a significant c orrelation between survival and T factor proposed by AJCC (P = 0.022). Conclusions: The new classification seems useful for estimating posto perative prognosis of the resected patients with lung cancer accompani ed by ipsilateral pm. (C) 1997 Elsevier Science B.V.