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The Annals of Thoracic Surgery, Vol 44, 340-343, Copyright © 1987 by The Society of Thoracic Surgeons
JI Miller and CR Hatcher Jr
Surgical resection is the treatment of choice for non-small cell
bronchogenic carcinoma, and it is the only method providing prolonged
arrest and chance for cure. From 1974 through 1984, 32 patients with marked
impairment of pulmonary function had a limited resection for carcinoma of
the lung. Marked impairment is defined as a maximum breathing capacity less
than 35 to 40% of predicted, forced expiratory volume in one second less
than or equal to 1 liter, and forced expiratory flow (FEV25-75) of less
than or equal to 0.6 liter. Limited resection is defined as an operation
that is less than a lobectomy, generally a wide wedge or segmental
resection. The pathological stage of disease was Stage I in 31 patients and
Stage II in 1 patient. Ten patients were treated by segmental resection and
22 by wide wedge resection. Two-year and three-year survival is 84 and 78%,
respectively, and 10 patients (31%) have survived for five years. Recurrent
disease developed in 8 patients, 5 of whom died. Recurrence was highest
when the lesion crossed an intersegmental plane. In 1978, postoperative
radiation therapy was added to the treatment of all patients whose lesion
crossed an intersegmental plane. Since then, 18 patients have undergone
wedge resection and postoperative irradiation with only 2 local recurrences
at two years.
ARTICLES
Limited resection of bronchogenic carcinoma in the patient with marked impairment of pulmonary function
Joseph B. Whitehead Department of Surgery, Emory University School of Medicine, Atlanta, GA.
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