For release: February 15, 2000
Contact: Kimberly Lynch, ACCP (847) 498-8341
[email protected]
LUNG CANCER PATIENTS SHOW SIGNIFICANT SURVIVAL RATE
In the February issue of CHEST, Dutch researchers reported a significant 41 percent five-year overall survival rate among 2,263 patients who had surgery for non-small cell lung cancer (NSCLC).
Writing in the peer-reviewed journal of the American College of Chest Physicians, Jules M.M. van den Bosch, M.D., Ph.D., FCCP, of the Department of Pulmonary Disease, Sint Antonius Hospital, Nieuwegein, The Netherlands, along with three colleagues, showed that survival in patients with complete resection was significantly better. Five-year survival was 44.3 percent in patients with complete resection versus 16.2 percent for incomplete surgery. Incomplete resection occurs more frequently in those with advanced disease.
"For patients with NSCLS," said Dr. van den Bosch, "surgery and complete removal of the primary tumor and its involved lymph nodes remains the most effective mode of treatment."
"Lung cancer staging...is an important aid to determine the clinical course of the patient and the success of treatment," added Dr. van den Bosch. "It is based on the anatomic extent of the disease as defined by the grade of the primary tumor, any regional lymph node involvement, and whether distant disease is present."
According to the investigators, using the 1997 staging criteria, there were significant differences in survival between tumor stages 1A (63 five-year survivors) and 1B (46 five-year survivors); IIA (52 five-year survivors) and IIB (33 five-year survivors), and IIIA (19 five-year survivors).
The researchers said that during the last decade, more aggressive surgery had led to more liberal inclusion of patients with advanced disease. Dr. van den Bosch noted that the number of patients with advanced lung cancer in this study was slightly higher.
For this research, resection was considered complete in almost 90 percent of the patients when: the surgeon was certain all known disease had been removed; resection margins from removed tissue were free of disease on pathologic examination; and the highest lymph node was free of disease in a pathologic examination utilizing microscopy.
In focusing on patient data from 1970 to 1992, the Dutch researchers studied 2,196 men (93 percent) and 165 women. Deaths within 30 days of the operation were excluded from the study. Tumors were classified as squamous cell carcinoma in 1,607 patients (68.1 percent), adenocarcinoma in 542 (23 percent), adenosquamous in 88 (3.7 percent), and undifferentiated large cell carcinoma in 124 (5.2 percent).
According to the researchers, survival was significantly better in patients who had squamous cell lung carcinoma compared with patients who had non-squamous cell carcinoma, based on one estimate of disease extent from pathologic examination of resected specimens. They also pointed out that until four years after surgery age at operation did not influence survival, and after five years, patients over age 65 had a significantly lower survival rate.
He said that in his cohort of patients, re-analysis of data showed no relationship between lymph node involvement and histology or tumor size.
CHEST is published by the American College of Chest Physicians which represents 15,000 members who provide clinical, respiratory, and cardiothoracic patient care in the U.S. and throughout the world.
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Reporters may wish to contact Kimberly Lynch of the ACCP at (847) 498-8341 for a full copy of this article. She can also be reached by fax at (847) 498-5460 or by e-mail at [email protected]. Dr. van den Bosch can be reached by phone at 31-0-30-6092058 or by email at [email protected].
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