Segmental pulmonary resection for cancer.

Segmental pulmonary resection was employed in 61 patients with cancer whose ages ranged from 44 to 82 years (average 62 years). There were 39 patients in the curative group with disease staged T1N0M0, 9 patients in the limited group with residual thoracic disease, 8 patients in the palliative group with severe chronic obstructive pulmonary disease, and 5 patients in the metastatic group. Two patients died within 30 days after operation. Significant palliation was obtained in the limited and metastatic groups. Most patients in the palliative group died from emphysema within 1 to 2 years after resection. Early survival rates (64 percent after an average of 16 months) in the curative group were not as good as had been anticipated because small peripheral, asymptomatic, and predominantly scar adenocarcinoma spread systemically more than similar bronchogenic cancer. Furthermore, about half the deaths were related to the many other diseases of smoking. However, the local recurrence rate of 5 percent was low. Segmentectomy was well tolerated, even in patients with compromised pulmonary function.