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Clinical InvestigationsPrognostic Assessment of 2,361 Patients Who Underwent Pulmonary Resection for Non-small Cell Lung Cancer, Stage I, II, and IIIA
Section snippets
Materials and Methods
From 1970 through 1992, 2,799 patients underwent surgery for NSCLC, 2,559 of whom underwent resection. Of this latter group, 2,361 patients underwent resection for stage I, II, or IIIA primary NSCLC.1 None of the patients had received previous treatment for NSCLC. Staging definitions for the T (primary tumor), N (regional lymph nodes), and M (distant metastasis) components were used according to the International Staging System for Lung Cancer.1
Patient age ranged from 26 to 85 years, with a
Results
Within 30 days after surgery, 91 patients died (3.9%), 43 of whom patients had undergone pneumonectomy. Postoperative death was related not to disease stage but to the extension of the resection (7.2% for pneumonectomy; 5.4% for bilobectomy; 2.5% for lobectomy; 0.6% for small resections) and the patient's age (6.4% in elderly patients and 2.1% in patients aged < 65 years). Seven patients were lost to follow-up; therefore, 2,263 patients were included for survival analyses. Overall 5-year
Discussion
Lung cancer staging—based on anatomic extent of the disease and using the TNM classification system—is an important aid to determine the clinical course of the patient and the success of treatment.1, 2, 3, 8 For patients with NSCLC, surgery and complete removal of the primary tumor and its involved lymph nodes remains the most effective mode of treatment.9 The postresection survival of our patients with primary NSCLC of stages I, II, and IIIA is comparable to the survival reported by other
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