MADRID, SPAIN -- October 12, 1999 -- Nearly half the surgical operations on a large series of Dutch patients with lung cancer have been found to be 'futile', according to new research presented at the European Respiratory Society Annual Congress (ERS), in Madrid, Spain.
The findings have prompted the research team, led by Dr. Gerada Herder from the department of pulmonary and clinical medicine at the Free University Hospital, in Amsterdam, The Netherlands, to call for new staging processes to better identify those patients who will benefit from surgery.
In this study, the researchers staged 220 patients from a large general hospital and 117 patients from a university hospital (I/II clinically resectable, III/IV clinically unresectable) in an attempt to identify those who could benefit from surgery. Surgery was considered futile when there was a retrospective benign lesion, when there was unresectable lung cancer, or when there was relapse within 12 months after surgery with curative intent.
In all, 168 patients had surgery and 75 operations were judged to be futile. Of the patients who had surgery, 33 were found to be inoperable during surgery, 14 had a metastasis within 12 months of surgery, four developed a lymph node nodule within 12 months and the rest were found to have a benign tumour or to have developed another tumour.
The patients, whose mean age was 65, underwent a series of tests and investigations before staging including X-rays, nuclear investigations, bronchoscopy, transthoracic punction biopsies and mediastinoscopy.
In her presentation on 'Staging of non-small cell lung cancer in two large Dutch hospitals', Dr. Herder said: "Despite a thorough work up, surgery was not the effective treatment in about 50 percent of surgically reated patients in both clinical settings, and this applies to every step of the system. Better staging procedures are needed. The staging we use is not good enough, because up to a half of patients get no benefit from major unpleasant surgery such as thoracectomy."
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