A retrospective analysis of 10-year survivors from carcinoma of the lung.

From 1949 to 1972, 4732 patients with carcinomas of the lung were seen. Of these, 118 patients were found alive at 10 years from their initial diagnosis and treatment. This number represents only 2.5% of all lung cancers seen because many have been lost to follow-up within the first ten years, and their true status is not known. The authors attempted to look at the patient characteristics that might have influenced long-term survival. A case-matched study was also done of patients with carcinoma of the lung who lived less than 2 years and who had the same age, sex, histology, and year of diagnosis. In the long-term survivors, the median age was 57 years, 2 of 3 had epidermoid carcinoma, 86% were smokers, 76% were symptomatic, and 70% had one or both parents alive at age 70 years or older. There was no difference in these variables in the case-matched group. Of the 118 long-term survivors, 91 were men and 27 were women. Sixty-seven percent had Stage I disease, 13% Stage II, and 20% Stage III. None had distant metastasis at presentation. Of the 118 patients, 115 had surgery. Eighteen of the 115 surgically treated patients also had postoperative external radiation. Three patients with Stage III disease received radiation without surgery. None had recurrence of their cancer, 27 developed new cancers, and 70% of these were new lung cancers. Although the majority of the long-term survivors had Stage I cancers, a third had Stage II or III disease. No long-term survivor died of his original disease, suggesting that a 10-year survival is adequate proof of cure in carcinoma of the lung.