Locally advanced lung cancer treatment: personal experience of 588 stage III operated on patients

From 1967 to 1988, we operated on 1507 non-small cell lung cancer. Complete data concerning patients at stage III are available for 501 of them. In 73% of cases the histological type was epidermoid, in 22% it was adenocarcinoma and in 5% large cells anaplastic carcinoma. Explorative thoracotomy (E.T.) was performed in 45% of interventions whereas curative resections in 55%. Sixty-two percent of these patients underwent pneumonectomy and thirty-eight percent lobectomy. Exeresis interventions were performed in patients at stage III A in 86% of cases, whereas in patients at stage III B in 14% of cases. Five years survival rate for stage III non small cell lung cancer is 17% whereas in stage II is 33% and in stage I is 52%. The only valuable prognostic factor seems to be the size of parenchymal exeresis. Indeed, survival rate after lobectomy is 24% versus 13% after pneumonectomy. In our experience the different survival between tumours at stage III A and tumours at stage III B are not significant, when the unexpected intraoperative finding of marginal infiltration of mediastinal organ is still compatible with resection. Also the survival rates between the two histological types are not statistically significant.