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The authors present prognostic information on recurrence and survival for resected Stage I lung cancer patients with squamous cell carcinoma, adenocarcinoma or large cell carcinoma. The data derive from 392 carefully staged patients and include results from the history and physical examination, preoperative laboratory tests, nature of the surgery, complications, initial pathologic findings following surgical resection, and final pathologic review. A simple multivariate model of recurrence, which is used to classify patients into low, intermediate, and high‐risk groups, is based on tumor size and location (T1, T2), histologic type (squamous, nonsquamous/mixed) and nodal status (N0, N1). To model survival, the performance status and the presence of empyema, pneumonia, or wound infection were added to the previous factors. Not all factors associated with increased mortality are associated with increased risk of recurrence, and, in particular, postoperative empyema, pneumonia or wound infections carry an increased risk of death only. Serial measurements of performance status and leukocyte count have the potential for monitoring for increased risk of recurrence and death.

Thirty‐seven patients with small cell carcinoma of the lung were staged prior to therapy. The incidence of “extensive” or extrathoracic disease was 84%. Fourteen percent had CNS metastases. Bone marrow metastases were present in 47%. Laboratory and/or clinical evidence for a paraneoplastic syndrome was present in 26%. The majority of patients were treated with a three‐drug combination plus radiation therapy of the lung primary. Eighty‐eight percent of the patients treated with cyclophosphamide and vincristine had an objective response. Methotrexate was felt to be superior to Procarbazine as the third drug because fewer instances of progressive disease were noted during that portion of the chemotherapy cycle in which the third drug was used. Of 26 patients treated with both chemotherapy and radiation therapy, 55% had a complete response. The CNS was one of the sites of relapse in 21% of patients, and was involved by tumor in 45% of patients autopsied. The median survival in patients treated with both chemotherapy and radiation therapy was 9.5 months, and was significantly better (p < 0.005) than the median survival of a group of 45 patients from our tumor registry.

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The use of PCI remains controversial outside the setting of a clinical trial.