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The Journal of Cardiovascular Surgery 2002 October;43(5):723-7

language: English

Surgical treatment of stage I lung cancer. Results and prognostic factors

Porrello C., Alifano M., Forti Parri S. N., Sanna S., Lacava N., Corneli G., Boaron M.

Depart­ment of Tho­racic Sur­gery Mag­giore Hos­pital, ­Bologna, ­Italy


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Back­ground. The ­aims of the ­present ­study ­were: 1) to ­study the ­type and ­extent of resec­tion in ­patients ­with path­o­log­ical ­stage I ­lung ­cancer; 2) to eval­uate the ­results of sur­gical treat­ment; 3) to ­assess prog­nostic fac­tors. Set­ting: a ter­tiary ­referral gen­eral hos­pital.
­Methods. Ret­ro­spec­tive ­review of clin­ical ­records of 296 ­patients oper­ated on for path­o­logic ­stage I ­lung ­cancer ­between 1989 and 1998. ­Mean ­follow-up ­period was 33.1±28.1 ­months. Sur­vi­vals ­were cal­cu­lated by the actu­arial ­method and com­pared by the ­long-­rank ­test. Age, sex, ­tumor ­size, ­type and ­extent of resec­tion and his­to­logic ­type ­were eval­u­ated by uni­var­iate and mul­ti­var­iate anal­isis.
­Results. Two hundred and forty-five lobec­to­mies, 39 pneu­mo­nec­to­mies, 5 seg­mental resec­tions and 7 ­wedge resec­tions ­were per­formed. ­Overall actu­arial 5-­ and 10-­year sur­vi­vals ­were 62 and 49%, respec­tively. ­Stage Ia ­patients ­showed sig­nif­i­cantly ­better 5- and 10-­year sur­vi­vals (76 and 54%, respec­tively) as com­pared to ­Stage Ib ­patients (57 and 46%, p=0.007). Uni­var­iate anal­ysis ­showed no sig­nif­i­cant dif­fer­ence in sur­vival ­according to the age, the sex or the ­extent of resec­tion. The his­to­log­ical ­type influ­enced the out­come (p=0.05): 5-­year sur­vival ­rate ­were 57, 67, 75% in squa­mous ­cell car­ci­noma, adenocarcinoma and bron­choal­ve­olar car­ci­noma, respec­tively. At mul­ti­var­iate anal­ysis ­stage and his­tology ­were iden­ti­fied as inde­pen­dent prog­nostic fac­tors.
Con­clu­sions. Sat­is­fac­tory ­results in ­terms of ­suvival can be ­achieved fol­lowing sur­gery for ­stage I ­lung ­cancer. The T ­status and the his­to­logic ­type sig­nif­i­cantly influence sur­vival.

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