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Postoperative prognosis in patients with non-small cell lung cancer according to the method of initial detection.

Hanagiri T, Sugio K, Mizukami M, Ichiki Y, Sugaya M, Ono K, Yasuda M, Nozoe T, Takenoyama M, Yasumoto K

Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan. hanagiri@med.uoeh-u.ac.jp

INTRODUCTION: In this study, we investigated the difference in the surgical results of non-small cell lung cancer according to the method of initial detection. METHODS: We reviewed the medical records of 796 patients who underwent pulmonary resection for non-small cell lung cancer between 1994 and 2005. The subjects consisted of 171 patients whose cancer was detected by a medical checkup or mass health screening (group I), 316 patients who were under evaluation for other diseases or with symptoms related to other diseases (group II), and 309 patients with lung cancer-related symptoms (group III). The mean ages of the three groups were 63.2, 69.7, and 68.2 years old, respectively, with group I being significantly younger than the other groups. The proportion of women in the symptomatic group was significantly lower than that of men. RESULTS: Pathologic stage I lung cancer was found in 112 (65.5%), 209 (65.2%), and 110 (35.6%) patients in groups I, II, and III, respectively. In comparison with stage II-IV cancer, stage I cancer was diagnosed more frequently in group I. According to the histologic type, adenocarcinoma was found in 132 patients (77.2%) in group I. However, squamous cell carcinoma was detected in only 27 patients (15.8%) in group I. The overall 5-year survival rates were 71.9%, 60.2%, and 48.0% in groups I, II, and III, respectively. Groups I and II had significantly better prognoses than group III. CONCLUSION: Groups I and II had favorable prognoses, and the presence of symptoms related to lung cancer was a significantly unfavorable prognostic factor independent of all other factors.

Published 2 October 2007 in J Thorac Oncol, 2(10): 907-11.
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