Abstract
A total of 292 cancer patients were treated in our department from April, 1973, through April, 1980. Resection of tumor was performed on 206 of the cases. Operative death occurred in two cases.
The disease was at stage III in 135, of which 74.0% had T3 lesions and 66.7% had N2 disease. Tumor resection was performed on 103 of the stage III cancer patients. Surgery for the T3 lesions consisted of combined resection of the surroundirig structures and, for the N2 lesions, extended operation with extensive dissection of the mediastinal lymph nodes. Chemo-and immunotherapeutic agents were administered pre-and postoperatively as adjuvant therapy.
The five-year survival rate was 13.6% in the stage III patients who had had complete or incomplete tumor resection. For only those patients who had complete tumor resection, the survival rate was 22.4%. The three-year survival rate was 12.9% in 75 patients with combined resection of the adjacent structures, but it was 18.9% if the patients with incomplete resection were excluded.
The prognosis was favourable in cases of combined chest wall resection. Relatively longer survival was experienced in cases of adenocarcinoma with No or N1 lesions and in cases undergoing chest wall resection. It was confirmed that postoperative treatment with OK-432, a streptococcal preparation for immunotherapy, is effective in prolonging survival of cases undergoing extended operation.
Although the survival rate of stage III patients is low compared to that of the patients in stages I and II, these results encourage us to perform aggressive surgery with the aid of pre-and postoperative adjuvant therapy in selected cases of advanced lung cancer.
