Does the location of lung cancer affect its prognosis?

A series of 446 patients with lung cancer, comprising all the patients in a defined population who had lung cancer diagnosed over 4 years, were prospectively studied and followed up for 5 years or until death. Epidermoid carcinoma was relatively more common among the central tumours, and adenocarcinoma among the peripheral tumors; 79% of adenocarcinomas, but only 36% of epidermoid carcinomas being peripheral. The survival rate was significantly worse for the patients with central rather than peripheral tumours, although even so, only 3% of the former and 7% of the latter were alive 5 years after diagnosis. The patients with a tumour extending to the main bronchi had a poor prognosis. There was no consistent difference in the lobar distribution of the various histological types, and the prognosis was similar irrespective of the lobar location of the tumour. Unless located in the main bronchi, the site of lung cancer may be of little importance to the prognosis.