Five-Year Survival After Surgery for Bronchogenic Carcinoma

An Analysis of Twenty-one Cases

¹ The Department of Thoracic Surgery, The Cleveland Clinic Foundation and The Frank E. Bunts Educational Institute.
² The Department of Thoracic Surgery, The Cleveland Clinic Foundation and The Frank E. Bunts Educational Institute., Fellow in the Department of Thoracic Surgery.

1. The diagnosis of bronchogenic carcinoma was established in 347 patients at the Cleveland Clinic between January 1, 1949, and December 31, 1953.

2. Exploratory thoracotomy was carried out in 209 patients but in only 85 was pulmonary resection feasible. Of the latter, 21 patients lived five years or more after surgery.

3. The records of the survivors were scrutinized from the standpoint of age, sex, symptoms, signs, roentgen, bronchoscopic and pathologic findings, and surgical procedure performed.

4. No feature consistently distinguished the survivors from the nonsurvivors, although lack of symptoms, peripheral location of the tumor, and squamous-cell type of cancer were frequent findings in the survivors.

5. Thirty-one per cent of the patients who underwent lobectomy lived five years, but only 16 per cent of those who underwent pneumonectomy lived that long. This reflects the fact that lobectomy was done for more favorable cancers rather than that lobectomy is a procedure superior to pneumonectomy.

6. Factors other than those studied, e. g., host resistance and immunity, and inherent growth potential of the tumor must also influence survival, and the role of these is at present obscure.