PURPOSE: Little information exists regarding long-term survival after curative lung cancer resection. We describe very long-term survival of patients after anatomic lung cancer resection resulting in cure of index cancer. We hypothesized curative resection resulted in normal longevity.
METHODS: Patients undergoing lobectomy or pneumonectomy for primary lung cancer (index) by a single thoracic surgery group, prospectively entered into a clinical database, were studied if > 15 years follow-up. Annual follow-up is via tumor registry and direct patient & physician contact. Patients without medical records >3 years are searched in Social Security Death Index.
RESULTS: 556 patients underwent first time “curative” resections for lung cancer from 1980 - 1995. There were 443 lobectomies and 113 pneumonectomies. Average age was 64.9 years with 58% male. The mean, maximum and total follow-up is 6, 28, and 3309 years. There were 25 hospital deaths (4.5%), 248 late deaths related to lung cancer and 241 late deaths unrelated to index lung cancer (including 20 unknown). For the 309 patients who did not die of index lung cancer, the 5, 10, 15, 20 and 25-year survival were 66%, 40%, 21%, 9% and 1%, respectively, while age, gender & year matched controls were 85%, 62%, 47%, 37% and 28%.
CONCLUSIONS: Survival of patients surgically cured of lung cancer is unexpectedly inferior to age, gender and year matched population.
CLINICAL IMPLICATIONS: The causes of excess mortality after curative lung cancer resection need to be identified.
DISCLOSURE: The following authors have nothing to disclose: John Handy, James Asaph, Gary Grunkemeier, YingXing Wu
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