Pulmonary cancer and its prognosis.A study of the relationship of certain factors to survival of patients treated by pulmonary resection

HIS INVESTIGATION was undertaken to de-T termine whether or not certain clinical and pathological findings in patients with cancer of the lung could be correlated with their survival after treatment by the success or failure of pulmonary resection.T h e pathological features specifically studied were the tumor cell types, the site of the tumor, the presence or absence of tumor in blood vessels, nerve sheaths, and lymph nodes, and the occurrence of cytological changes in the non-neoplastic epithelium of the resected specimen.Confirmation of the significance of blood vessel invasion and lymph node metastases as reported by others was particularly sought.639,14, 23 MATERIAL AND METHOD Clinical Data.Between Jan. 1, 1948, and June 1, 1953, 623 patients with carcinoma of the lung were seen by the Chest Service at Barnes Hospital, St. Louis, Mo.During this period, 225 (36%) of these patients underwent either pneumonectomy (192) or lobectomy (33) for the disease.Forty-seven (7.5%) of the 623 patients survived 5 or more years.Forty-six of them were treated by pulmonary resection; 1 other patient had radiation therapy for a nonresectable lesion after an exploratory thoracotomy and biospy.T h e 46 patients represent a 5-year survival of 20.3% of the 225 patients who had a pulmonary resection.Patients who had bronchial adenomas that were resected during this interval are not included.T h e cases in this study include 461 patients treated between Jan. 1, 1948, and July 1, 1952, and 162 patients treated in the ensuing year.I n a previous publication by Burford et al.,5 the results of treatment of 1,008 patients with