Influence of Empyema after Resection for Bronchogenic Carcinoma and Survival (Cooperative Study in Japan)

Abstract

6, 349 surgical cases of bronchogenic carcinoma collected from 48 institutions in Japan were analysed, and the following results were obtained: 1) The rate of pneumonectemy to lobectcmy was 1:4.5 in 2, 437 cases of curative operation, 1:2.0 in 1, 399 cases of semicurative operation, and 1:2.5 in total. Cases of pneumonectcmy were more on the left side, whereas cases of the right lobectomy were about twice as much as cases of the left one. 2) Postoperative empyema occurred in 178 cases (2.8%). The incidence was significantly higher in cases of the right pneumonectomy than in cases of the left pneumonectomy, and in cases of pneumonectomy than in cases of lobectomy. 3) Out of 114 patients who had suffered from postoperative empyema before 5 years or more, 15 died within 30 days. The incidence of hospital death increased as the clinical stage or the grade of curability worsened. 4) Five-year survival rate of the patients who had suffered from postoperative empyema was 50% in 34 cases of stage I, 44% in 25 cases of stage II, 19% in 32 cases of stage III, and nil in 5 cases of stage IV; and, 59% in 32 cases of curative operation, 58% in 19 cases of semicurative operation, and 9% in 45 cases of noncurative operation. As a whole, the rate was 35% in all 96 cases excluding 15 cases which died within 30 days and 3 other cases of unknown TNM classification. This rate was about the same as the average of the 6 previously reported results. The total of both figures is significantly higher than that of 1, 258 cases collected from the National Cancer Center Hospital and 3 other representative hospitals in Japan. Accordingly, it appears that postoperative empyema has a favorable influence on the survival of the patients.