1979 Volume 31 Issue 3 Pages 321-329
The pulmonary resections for 137 patients with primary lung cancer were performed from January,1971 to December,1978. One hundred and thirty-seven patients (95 males and 42females) aged 20 to 79 years (mean 59.3 years) were histologically classified into 68 of squamous cell carcinoma (49.6%),61 of adenocarcinoma (44.5%),5 of large cell carcinoma and 3 of small cell carcinoma. The surgical procedures consisted of 10 right pneumonectomies,25 left pneumonectomies,30 two-lobes-lobectomies and 72 lobectomies, and the curative operations were undergone for 65 cases of 137 (47.4%). The patients, whose ages were over 60 years old, were 75 of 137 cases (54.7%), inclusive of 15 cases of advanced aged patients over 70 years old. The surgical procedures for 75 patients of old aged group over 60 years old consisted of 5 right pneumonectomies,12 left pneumonectomies,15 two-lobes-lobectomies and 43 lobectomies, and the curative operations were performed for 35 of 75 cases (46.7%).
In the measurement of preoperative pulmonary functions including arterial gas anal ysis, cardiac index, mean pulmonary arterial pressure, total pulmonary vascular resistance and mean pulmonary arterial pressure during the occlusion of unilateral pulmonary artery, no significant difference was demonstrated between the younger aged patient-group below 59 years old and the older aged patient-group over 60 years old.
Postoperative five year survival rate of 137 pa tients was 33.2%, and, in the cases, whose surgical treatment was done in stage I or curative surgery was performed, five year survival rate was more than 50%. No significant difference was found between overall five year survival rate of 62 cases below 59 years old and that of 75 cases over 60 years old. However, the results of the younger patient-group below 59 years old were some little better than those of the older patient-group over 60 years old in squamous cell carcinoma and the results of the older patient-group over 60 years old were a few better than those of the younger patient-group below 59 years old in adenocarcinoma. Moreover, in the curative onelobelobectomy, five years survival rate of old aged patients over 60 years old was significantly better than that of the younger patients below 59 years old either in squamous cell carcinoma or in adenocarcinoma, and, on the contrary, the result of the younger patients below 59 years old was better in the curative two-lobes-lobectomies or pneumonectomies.
No definite correlation was demonstrated between the preoperative pulmonary functions and the cause of early death after surgery. However,3 of 4 cases dead within one month after surgery and 14 of 17 patients died from 1 to 6 months after surgery were belonged to the old aged patient-group over 60 years old. More particularly,2 of 3 cases dead within one month after surgery and 6 of 14 patients died from 1 to 6 months after surgery in the older patientgroup died of pulmonary complications (pneumonia or pulmonary insufficiency with pneumonia), although their preoperative pulmonary functions were so good as those of the younger patientgroup.
The surgical results in the advanced aged patients over 70 years old were 67.2% for one year survival rate,48% for two year survival rate,24% for five year survival rate and 19.5months for median survival time, which were almost similar to those of the patients below 69years old.
