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The Journal of Thoracic and Cardiovascular Surgery, Vol 78, 175-180, Copyright © 1979 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
AS Soorae and HM Stevenson
Sixty-four (14.7 percent) of 434 consecutive patients having pulmonary
resection for bronchogenic carcinoma were found to have microscopic
residual tumor on the cut margins of the resected specimens. These subjects
were further subdivided histologically into those with direct extension of
the tumor (34 patients), lymphatic permeation (14 patients), clumps of
cancer cells in parabronchial tissues (six patients), and the presence of
carcinoma in situ change (10 patients). Bronchopleural fistulas developed
in eight (12.5 percent) of 64 patients. The operative mortality rate was
15.6 percent, with four of the deaths occurring as the result of
bronchopleural fistulas. Thirty- two patients (50 percent) survived 1 year,
21 (32.8 percent) survived 3 years, and 15 (23.4 percent) lived for 5 years
or more. The patients with tumor in the submucosal and peribronchial
lymphatics had the worst prognosis. 78.6 percent having died within 1 year
and the remainder within 3 years. All 5-year survivors were men with
squamous cell carcinoma and had relatively small tumors (mean diameter 2.9
cm). No direct relationship between the length of the resected bronchial
stump and survival could be established; a short stump did not preclude
long survival. The possible factors involved in the relatively high 5 year
survival rate in this group of patients and the therapeutic implications of
these factors are discussed.
ARTICLES
Survival with residual tumor on the bronchial margin after resection for bronchogenic carcinoma
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