1 0 5

Modini, C., Cicconetti, F0, Botti, C.,

Buttini, G.L., Moreschi, M., Micozzi, I., Fazio, M., Stipa, S. ist Department of Sur- gery, University of Rome, Italy.

i00 out of 527 pts. with a minimum fol- low-up; of 15 yrs. were retrospectively selected according to the following criteria: histologically proven bronchopulmonary car- cinoma, presumed curative resection, no adjuvant therapy before or after the sur- gical treatment. Data were collected and processed by on I.B.M. 370/158 computer. The median survival of the study group was 15 mths (7 operative mortalities were excluded) and 5, i0 and 15 yrs crude sur-

vival rates were 23.65% (22/93), 16.1% (15/93) and 10.7% (10/93) respectively. Assuming the median survival as dependent variable (0=less than 15 mths, l=more than 15 mths) 41 different parameters were con- sidered as independent variables in a mul- tivariate analysis (stepwise multiple re- gression). Three parameters were accepted: TNM stages (stage I-II vs stage III), kind of resection (lobectomy vs pneumonectomy),

extent of resection (simple vs extended) (F05.355, F=4.249, F=0.168). Combining these characteristics it was possible to obtain 8 groups able to unequivocally de- fine every single patient. We used the same dependent variable and these 8 groups as independent ones to set up a new step- wise regression analysis. According to the obtained "t values" for each step we as- signed a score to each individual. Only for purpose of tabulation we divided our patients in four score groups (from - 0.644 to 2.136). The mean scores of each group were correlated to the survival rates at 3-5-10 and 15 yrs, showing that the high- er was the score the higher was the survi- val rates in the study group. The scoring system was then tested in a control group of 65 patients with homogeneous characteri- stics, looking for the regression equati- ons of mean scores vs survival at 3-5 yrs (Y=21.93 + 12.76 x at 3 yrs; Y=15.57 + 9.21 x at 5 yrs). The goodness of the fit

between study and control groups was furtherly tested under the null hypothesis of identity which was accepted at an alfa value of 0.001 with 6 d f. In conclusion this score system based on a comparison against median value of survival enables

us to predict long term survival after a briefer period of observation, waiting the death's occurrence of 50% of the patients

plus one.

Surgical Treatment For Llmg Cancer: A ~,itivaried Analysis of Long-Term Survival. Di Giorgio, A., Sammartino, P., Mosticoni, S., Di Lauro, G., Baffoni, S. I Clinica Chirurgica, Universit~ di Roma, Italia.

In a series of 456 lung cancer patients

treated with surgical resection from a mini-

mum of 5 years and being followed-up, the sur- vival rate was analyzed with relation to seve- ral prognostic parameters. Particularly, the survival rate was related with the histolo- gical type, p-stage, host immune response, ex- pressed as degree of lymphocyte infiltration of the primary tumor (LI). The significance of such correlations was evaluated by the analysis of variance performed with a data bank from a computer UNIVAC ii00 at the EDP Center of Rome University. This test has shown that the survival data are statistically re- lated with the p stage and LI but not with the histological type (Tab.).

As for the prognostic value of such para- meters, it was possible to assess that pa- tients with neoplasms at an early stage and with evident immune response (LI > 2) had better survival rates as compared to the other cases, apart from the histological type of

neoplasm.

A N O V A 3 WAYS

SOURCE S S q d I M S q F p

HISTOLOGICAL 166... 1 168_. 0.46... N,S. TYPE (A)

p STAGE (B) 28.52.- 1 28.52.., 7.87. < 0.01

LI (C) 31,68. . I 3 1 6 8 . 8.75_ < 0 . 0 1

A X B O 02 . 1 0.02 .. 5 7... E.03 N.S.

A X C 4.68... I 4.68 .. 1.29- N,S.

B X C 2.52. . I 2.52 .. 0.69... N.S.

A X B X C 17.52., 1 ~7 52,.. 4,83.., =0,05

Surgical Treatment For Small Cell Lung Cancer (SCLC): Long-Term Survival. Di Giorgio, A., Sammartino, P., Di Lauro, G., Caramanico, L., Baffoni, S. I Clinica Chirur- gica, Universit~ di Roma, Italia.

The best therapeutic approach to small cell lung cancer (SCLC) has long been a rather con- troversial issue. The present research was un- dertaken in order to assess results of surgi- cal treatment for SCLC obtained at a single institution and to analyze some possible prog- nostic factors which might influence long- term results. The clinical records of all lung cancer patients observed at our institu- tion during the period 1950-1982 were examined. Complete data were available in 1802 cases; histological material was reviewed and clas- sified according to W.H.O. criteria. SCLC was diagnosed in 288 patients (intermediate cell carcinoma 189 cases, oat cell carcinoma 99 cases). Resection was performed in 150 cases (147 curative, 3 palliative), 73 patients were explored, and 65 were deemed unsuitable for surgical treatment. Overall 5-year survi- val rate after resection was 20,7%. Long- term prognosis was significantly correlated to p-TNM (p< 0,002) and host's immune respon- se as evidenced by circulating peripheral lymphocytic infiltration (p < 0,03), regional lymph node reactivity (P.C.A., S.H. and C.A.

development) (p < 0,0001). Patients treated