A review of some important problems concerning lung cancer. The importance of complete preoperative assessment in bronchogenic carcinoma.

Part I of this review described the pathogenesis of lung cancer and emphasized that it was largely a preventable disease. In the present paper, attention is drawn to the prevalent but false impression that treatment of established disease is quite in-effective. In eight consecutive series of cases (over 2300 patients) the authors have seen a change in the clinical environment in which lung cancer is treated-from one of discouragement and apathy to one of outspoken encouragement and enthusiasm.Complete preoperative assessment-an evaluation of the biology of the tumour-host relationship as well as technical resectability-avoids unnecessary surgical intervention and stimulates a trend to earlier referral. This has permitted increasing use of resection with a declining mortality and a continuing improvement in overall survival. On the basis of present resectability rates (37.5%) and a 39% five-year survival rate in those who have had curative resection, it is estimated that current over-all five-year salvage should exceed 13%. This is more than a five-fold increase in survival for all patients compared to that achieved by treatment before 1952.