Chest
Volume 71, Issue 5, May 1977, Pages 644-650
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Symposium on Lung Cancer
Patterns of Survival in Lung Cancer

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Topographic Studies

For over two decades of teaching medical students, I have used a topographic classification of lung cancer1 (based on the actual location of the tumor in the lung), which correlates the symptoms, signs and radiographic findings. This classification has also proven to be very useful in studying the results of surgery and other therapy. The four divisions of this classification1 are: (1) cancer arising in the main bronchus; (2) cancer arising in the lobar bronchus; (3) cancer arising in the

Pleural Involvement

As noted in Figure 2, the subpleural location of the tumor offers the poorest opportunity for a five-year survival (approximately 8 percent of the cases in our experience1 and 7 percent in the series of Overholt et al10). We have had no patients who survived for five years when there was pleural fluid present with positive cytologic findings and pleural implants. In fact, it is rare for such a patient to survive for more than one year.

Although it is technically possible to strip the parietal

Conclusion

The survival of a patient with pulmonary carcinoma is the result of a complex interplay of factors involving the patient's immunologic status, the growth characteristics of the cancer, and the treatment employed. The location of the primary carcinoma of the lung, its size, the presence of metastasis to lymph nodes and distant metastasis, and the completeness of the resection each have an important bearing on survival. The increased growth potential of the poorly undifferentiated carcinomas

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