<原著>肺癌の手術予後に関する臨床的ならびに病理学的検討 : 〔前篇〕臨床的検討

Abstract

A series of 608 patients with lung cancer was reviewed. Of this series, 262 were subjected to pulmonary resection. Therefore, the resectability was 42.8% for the whole series. Patients who were regarded as inoperable at thoracotomy were 126 and constituted 20.8% of the whole series. Three-year-survival rate was 38.4% and five-year-survival rate was 32.3% for the whole group receiving pulmonary resection, while the 3yr survival rate was 52.6% and the 5yr rate was 47.6% for subgroup receiving curative resection. Sixty two were lung cancers less than 3cm in diameter. Forty six of them received curative resections, and the remainder received palliative resection or exploratory thoracotomies. The 5 yr-survival rate after pulmonary resection for this group was 50%. The postoperative prognosis of lung cancers less than 2cm in diameter was so favorable that they should be called "early lung cancers" from the clinical point of view. The survival-rate was best for cancers of the right lower lobe and worst for those of the left upper lobe. Volume-doubling time of lung cancers ranged from 21/2 to 15 months : No significant relationship between the volume-doubling time and the postoperative prognosis was seen. There was no significant difference of prognosis between peripheral and central (hilar) cancers. The presence of metastases to hilar lymph nodes has been shown to be a dominant factor influencing prognosis in carcinoma of the lung. For patients in whom the lymph nodes were tumor free or lymph node involvement was limited to broncho-pulmonary nodes, the 5 yr-survival rate was more than 60%. For patients in whom lymph node involvement was found beyond the tracheal bifurcation, the 5 yr-survival rate was about 10%.