Long-term results and patterns of disease recurrence after radical operations for lung cancer.

Long-term results and patterns of disease recurrences after radical operations for lung cancer between 1975 and 1984 were investigated. Eight hundred fifty-two patients (76.1%) with lung cancer underwent operations during this period. Radical operations were performed on 648 patients. There were 326 (50.6%) pneumonectomies, 314 (48.5%) lung resections (lobectomies), and 8 (1.2%) segmentectomies. Long-term survival rates of 542 patients were studied. In 49.2% of the patients survival was beyond 3 years; in 33% of the patients it was beyond 5 years. Five-year survival was observed in 40.3% +/- 2.5% of patients with N1 and in 19% +/- 4.9% of patients with N2 disease. The differences in survival rates between patients with epidermoid cancer and adenocarcinoma were slight and statistically insignificant. The prognosis was poor in patients with small-cell cancer, large-cell cancer, and dimorphous cancer. The causes of death were studied in 193 patients. Disease recurrence was diagnosed in 75.1% of cases. Bronchopulmonary and concomitant diseases accounted for 19.7% of deaths in these patients. In 5.2% of the patients malignant tumors occurred in other organs. Local-regional recurrences were diagnosed in 33.8% of patients, distant metastases occurred in 55.2% of patients, and 11% of patients had combined disease recurrences. The problem of disease recurrence classification is discussed in the article.