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Vol.45 No.3 contents | Japanese/English |
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- Original Article -
Surgical Outcome in Patients With Primary Lung Cancer Detected by Mass Screening and During Medical Examinations for Other Diseases
Takahisa Matsuoka1,2, Kazuhiro Ueda1, Manabu Sudou1, Toshiki Tanaka1, Hisashi Sakano1, Yoshikazu Kaneda1, Shinji Noshima1, Kimikazu Hamano11First Department of Surgery, Yamaguchi University School of Medicine, Japan, 2Department of Surgery, National Hospital Organization, National Sanyo Hospital, Japan
Objective and Methods. We retrospectively evaluated the differences of clinicopathological features and surgical outcome with regard to whether the lung cancer was detected by chest X-ray (CXR) without symptoms or by mainly respiratory symptoms. We classified 362 patients with lung cancer into 2 groups. In the mass screening and other disease group (n=225), their lung cancers were discovered by CXR mass screening or during medical examinations for other diseases. In the symptomatic group (n=137), their lung cancers were detected following the appearance of respiratory symptoms. Results. There was no significant difference in the age or gender between the two groups. Both tumor size and smoking index were lower, and pathological T1 (pT1) disease, pathological N0 (pN0) disease, partial resection or lobectomy, non-SCC (squamous cell carcinoma) and complete resection cases were more frequent in the mass screening and other disease group than in the symptomatic group (p < 0.01). A multivariate analysis of survival revealed that gender, smoking index, T-factor, N-factor, curativity and the detection method were significant prognostic factors (p < 0.05). Histology, operative method, differentiation, operative side and tumor location were not significant prognostic factors. According to the subset analysis, the detection method was a significant prognostic factor in patients with a smoking index of more than 800, pT1 disease, pN0 disease, partial resection or lobectomy and non-SCC cases (p < 0.01), but it was no significant in patients with a smoking index of less than 800, advanced disease, extended resection and SCC cases. Conclusion. 1) Early stage lung cancer were more frequent in the mass screening and other disease group. 2) The detection method was a significant prognostic factor in early stage lung cancer. 3) The detection method was not a significant prognostic factor in the extended resection and SCC cases.
key words: Primary lung cancer, Detection method, Mass screening, Multivariate analysis, Surgical outcome
Received: February 3, 2005
Accepted: March 29, 2005
JJLC 45 (3): 229-234, 2005
