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Ann Thorac Surg 1980;30:208-214
© 1980 The Society of Thoracic Surgeons

Articles

Selection by Mediastinoscopy and Long-Term Survival in Bronchial Carcinoma

M.H. Ashraf, F.R.C.S.*, P.L. Milsom, M.B.B.S., R.K. Walesby, F.R.C.S.

From the Department of Thoracic Surgery, Harefield Hospital, Middlesex, England

* Address reprint requests to Mr. Ashraf, Thoracic Surgical Unit, Harefield Hospital, Middlesex, England

In order to reduce the high rate of inoperability in patients with bronchial carcinoma, mediastinoscopy was carried out as a routine preoperative selection in 874 patients during 13 years. Two hundred thirty-six patients (27%) were found to have involved lymph nodes at mediastinoscopy and were not treated surgically. Follow-up data were available on 210 of them: 165 (79%) died within a year, 16 survived for 2 years, and 4 for 5 years. Pulmonary resection was carried out in 638 patients. Five-year survival in the series was 24.5% and 10-year survival (based on 104 eligible patients), 16.3%, including the operative mortality of 5.5%.

Mediastinoscopy has not improved long-term survival to any great extent. However, it has raised the rate of resectability to 97.1% and lowered the operative mortality without denying the patient a chance of cure.




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