In 678 cases of surgically resected
lung cancer, morphological factors influencing prognosis were evaluated, especially in
adenocarcinomas (283 cases) and
squamous cell carcinomas (270 cases). In
adenocarcinoma cases, sex, degree of differentiation, classification by cell type, lymphatic invasion, vascular invasion, pleural involvement, intrapulmonary
metastasis, grade of
scarring associated with a
tumor, atypia of cells and mitotic index were significantly evaluated. The scoring of these factors will contribute to the clinician's decisions on the necessity and selection of post-
adjuvant chemotherapy, especially even in Stage I. In
squamous cell carcinoma cases, location of
tumor,
tumor size, lymphatic invasion, vascular invasion and pleural involvement were also significantly evaluated. In 160 patients treated by
chemotherapy involving
cisplatin, chemotherapeutic response in
squamous cell carcinoma (39 cases) was more effective and survived longer these than in
adenocarcinoma (107 cases) and
large cell carcinoma (14 cases). In 233
non-small cell lung cancer patients treated by
chemotherapy, there were 33 cases of long-term survival more than 2 years; that is, 8 cases (3.4%) disease-free and 25 cases (10.7%) alive with
cancer. The group which remained disease-free for over 2 years, consisted only of patients with Stage IIIa or IIIb, and PR was achieved with
chemotherapy and radiation. Among patients who lived over 2 years, many
squamous cell carcinoma cases (5/6) remained disease-free. On the other hand,
adenocarcinoma was less responsive to
chemotherapy and almost all cases (24/27) were alive with
cancer. The relationship between the effectiveness of
chemotherapy and prognosis among histological subtypes was examined in
small cell lung cancer.(ABSTRACT TRUNCATED AT 250 WORDS)