Carcinoma of the lung, stage III. Experience with the new TNM-AJCC classification.

The records of 228 patients who underwent surgery for primary lung cancer in 1970-1986 were reviewed. In 115 cases (94 men, 21 women) the disease was in stage III according to the 1978 classification of the American Joint Committee on Cancer (AJCC). These 115 cases were retrospectively reassessed, using a recently proposed new TNM classification with subdivision of stage III into IIIa, in which the patients may benefit from surgery, and IIIb, in which surgery is not advisable. Stage IIIa disease was present at operation in 87 cases and stage IIIb in 28. Actuarial analysis of survival rates showed that the new subclassification permits identification of those stage III patients who may benefit from surgical therapy.

Evaluation of routine follow-up after surgery for breast carcinoma.

Close postoperative follow-up of patients with breast cancer permits the early detection of possible recurrence of disease. Such follow-up allows for the detection of a tumor mass, that is small enough to permit adequate treatment leading to an increased survival time and better quality of life. Thus we studied 85 patients treated by radical mastectomy in stages I, II, and III during the period from December 1977 to June 1982. Among 82 patients, 41 had axillary node involvement and received adjuvant chemotherapy with C.M.F. All patients received a strict follow-up. Thirty-two patients showed recurrence of the disease, with 28. 1% being discovered while still asymptomatic. Seventy-five percent of the recurrences were in the first 24 months after treatment. The frequency of involved sites was different between the group of patients with involvement and the group without involvement of axillary nodes. We have concluded that in asymptomatic patients certain exams need not be repeated at frequent intervals, and we have proposed a new follow-up protocol.