Choice of Operation in the Treatment of Bronchogenic Carcinoma

(A Review of 813 Cases of which 209 Were Treated by Resection)

¹ Grand Rapids, Michigan

1. A series of 813 cases of proved bronchial carcinoma seen from 1947 to 1963 is presented. Three hundred ninety-eight cases or 49 per cent were explored; and 209 or 52.5 per cent of these were resected. There were 106 pneumonectomies; 86 lobectomies and 17 excisions. The overall 30 day surgical mortality was 10 per cent.

2. The sex and age incidence is compared with other reported series. The men to women ratio was 9:1 and most of the patients were between 50 and 70 years of age.

3. The three-year or more survival was fully as good after lobectomy as after pneumonectomy. Lobectomy permits surgical excision in older individuals with greater safety and with a better postoperative functional capacity than after pneumonectomy.

4. The squamous type of carcinoma was by far the most common and offered the best prognosis with regard to long term survival. Metastasis to lymph nodes was an adverse factor in long term survival.

5. The objective of operation is the complete removal of gross tumor tissue and lobectomy usually will offer as much as pneumonectomy except for hilar lesions. Considerable paliation may be achieved by lobectomy or even a lesser procedure.