Resectable Bronchogenic Carcinoma A Study of 120 Cases

1) Clinically, resectable cancer of the lung appears as a trivial respiratory condition without any important characteristic of malignancy.

2) In 120 resected cases only one was a woman (0.83 per cent).

3) Physiopathology of cancer of the lung produces three mechanisms:

a) Bronchial obstruction.

b) Ulceration and infection.

c) Extrathoracic manifestations (endocrine?).

4) Fifty-one and six-tenths per cent of the cases began with bronchial symptomatology (cough, catarrh, hemoptysis).

5) The most common onset syndrome was the hemoptoic (28.3 per cent) and the second in order of frequency was the rheumatoid (18.3 per cent).

6) From the point of view of resectability rheumatoid onset syndrome is extremely useful because:

a) It is almost pathognomonic.

b) It occurs early.

c) It appears in small, peripheral tumors which are generally adenocarcinomas of relatively low malignancy.

7) Thoracic pain is not always an index of inoperability except when bone invasion is demonstrated by x-ray film.

8) Bronchoscopy was performed in 88 cases. It was positive in 42.3 per cent and negative in 57.7 per cent. Negative bronchoscopy is favorable to resection because it generally means that the neoplasm is peripheral.

9) In 16.6 per cent of cases the operation was performed after obtaining a true histological proof, and in 83.4 per cent the diagnosis was based on clinical and radiological criteria.

10) Antibiotics were of great importance in differentiating cancer of the lung from chronic suppuration.

11) The doubtful cases, or those in which it was impossible to arrive at an exact diagnosis, were operated according to the criterion of "surgical lung": "any chronic lung disease, either inflammatory or not, which acquires a tumor-like appearance."