A Review of Some Important Problems Concerning Lung Cancer

摘要

Part I of this review described the pathogenesis of lung cancer and emphasized that it was largely a preventable disease. In the present paper, attention is drawn to the prevalent but false impression that treatment of established disease is quite in-effective. In eight consecutive series of cases (over 2300 patients) the authors have seen a change in the clinical environment in which lung cancer is treated—from one of discouragement and apathy to one of outspoken encouragement and enthusiasm.Complete preoperative assessment—an evaluation of the biology of the tumour-host relationship as well as technical resectability—avoids unnecessary surgical intervention and stimulates a trend to earlier referral. This has permitted increasing use of resection with a declining mortality and a continuing improvement in overall survival. On the basis of present resectability rates (37.5%) and a 39% five-year survival rate in those who have had curative resection, it is estimated that current over-all five-year salvage should exceed 13%. This is more than a five-fold increase in survival for all patients compared to that achieved by treatment before 1952.