Lung cancer resection at Manmohan Cardio-Thoracic Vascular and Transplant Center—where lies our problem?
AbstractIntroduction: Resection rates of Lung Cancer are low in general and in countries like ours in particular. Advanced stage at presentation and poor general condition of the patient are the usual causes.Materials and methods: In this prospective observational study, hundred cases of lung cancer who presented to the Thoracic Surgery Unit between Oct 2011 to Oct 2012 were included.Results: The 6th and 7th decades together accounted for 72/100 patients. Male to Female ratio was 2:1. There were ! ve non-smokers with mean- 29.2 ± 14.2 pack yrs smoking history. Seventy-six patients presented with locally advanced disease while 21 had metastasized. Only three had local disease. The average time between onset of symptoms to ! rst contact with a doctor was 2.3 ± 5.3 months (range: 0- 35.6 months). Average time between ! rst contact to referral was 50.432 ± 65.657 days (range- 0 – 365). Only three patients were resected, one after neo-adjuvant chemotherapy. Advanced disease was the cause of unresectability in 95 cases. One of three patients with local disease had the pulmonary functions to allow the warranted resection. N2 disease with T1-3 on CT scan was found in 47. Three of these patients underwent mediastinoscopy and all con! rmed uninvolved N2.Conclusions: Lung resection rates in our center remain low. Late presentation leading to advanced disease and poor pulmonary reserves preclude resection in most. More liberal use of mediastinal staging and better assessment of pulmonary functions may allow us to improve resection rates.Key words: Lung cancer, mediastinoscopy, pulmonary functions, resection.
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