ABSTRACT
In the period 1988-1992, 74 consecutive radically resected patients with NSCLC were randomised to postoperative radiotherapy or surgery alone in order to evaluate the influence of postoperative radiotherapy on survival. There were 61 males and 13 females, aged 35-80 years, median 59 years. Their distribution by stage was as follows: pT1N2 = 19, pT2N2 = 54, pT3N2 = one patient; histology: 32 squamous, 32 adeno and 10 large cell carcinomas; surgery: atypical resection in six, lobectomy in 27, bilobectomy in ten, and pneumonectomy in 31 patients. In 27 patients, only one lymph node in a single mediastinal lymph node site was affected; in 31 patients more than one lymph node in one site; in 16 patients more sites were affected. In 35/74 patients radiotherapy of hilar and mediastinal sites with 3000 cGy in 2 weeks was performed. On December 31, 1994, 19 patients (26%) were still alive; 39/55 patients died of the following causes: locoregional failure-10(26%), distant metastases- 25 (64%), other tumor-unrelated causes-four patients (10%). Five-year survival rates did not show statistically significant differences between the irradiated and surgically treated patients only with respect to sex, pTNM stage, histology and frequency of locoregional failure. The number of metastatic mediastinal lymph nodes was the only significant prognostic factor (P < 0.005) in both randomised groups.
Subject(s)
Carcinoma, Non-Small-Cell Lung/radiotherapy , Lung Neoplasms/radiotherapy , Adult , Aged , Aged, 80 and over , Carcinoma, Non-Small-Cell Lung/mortality , Carcinoma, Non-Small-Cell Lung/surgery , Female , Follow-Up Studies , Humans , Lung Neoplasms/mortality , Lung Neoplasms/surgery , Male , Middle Aged , Postoperative Care , Prognosis , Radiotherapy, Adjuvant , Retrospective Studies , Survival RateABSTRACT
The prognostic significance of the above mentioned histological classifications is evaluated. The survival data of 259 supposedly radically resected patients is analyzed. The survival curves have been calculated according to the Kaplan-Meier method and compared with the Mantel-Cox test. The most important prognostic factors have been found and used in the stratification analysis. The diffuse type of cancer (according to Lauren) has significantly worse prognosis than the intestinal type only considering the same pT (pT3) and sex (male) or age group from 50 to 70 years. The infiltrative type of cancer (according to Ming) has a worse prognosis than expansive. The difference is insignificant even after stratification analysis. Worse prognosis of diffuse (or infiltrative) cancer is influenced more by the infiltration of regional lymph nodes than by the depth of infiltration, age or sex. WHO classification is less important as a prognostic factor. Signet ring cell type cancer has a worse prognosis considering age group 50-70 years.
