Læknablaðið : fylgirit - 01.05.1982, Page 50

48
The incidence among females is relatively
high, there being a male; female ratio of 2,8:1
from 1931—1954, 2,1:1 from 1955—1964 and 1,5:1
from 1965—1974. There have been about twice
as many lung carcinomas among females in the
urban as in the rural areas. The significance of
these figures may lie in the fact, that smoking
among females occurs mainly in the urban
areas and is reiatively much less common in
the rural group.
The National Cancer Registry was establis-
hed in 1955 and since then all the cases have
come from this institute’s files as well as from
the files of the various hospitals throughout the
country.
The hospital records of all the patients were
studied and the macroscopic descriptions of the
surgically reseeted lungs and necroscopies were
reviewed. All available microscopie slides have
been re-examined by one pathologist and the
tumours classified histologically according to
the WHO’s classification. There is a prepon-
derance of small cell anaplastic carcinoma
33,4% and adenocarcinoma 26,5% in this series.
Ep'.dermoid or squamous cell carcinoma were
found in only 24,7% per cent of cases and large
cell undifferentiated carcinoma in 15,4%.
During the period 1955—1974, 143 major
surgical procedures were performed for lung
cancer in Iceland; 68 explorative thoracotomies
and 75 resections.
The operability rate changed from 35,3% in
the first half of this period to 32% in the
second half and the resectability rate rose from
44% to 58% respect, due to fewer fruitless
thoractomies. Calculated from the total number
of lung cancer patients the resectability rate
rose from 15,4 per cent to 18,6 per cent in those
two tcn years periods.
The extent of the resections was as follows:
Pneumonectomies 58,7%, lobeetomies 38,6% and
segmental resections 2,7%.
Post operative mortality rate (30 days) is
4% in the resected series and 5,9% in the group
of exploratory thoracotomies.
In the resected series the five year survival
rate is 29,3 per cent which is a total salvage
rate of 5,1 per cent.
Prognosis is most favourable for patients
with squamous cell carcinoma, 40 per cent were
resected with 44 per cent five year survival
which means 17,6 per cent five year survival of
all patients who had this histologic type of
cancer.
Prognosis for patients with the more rapidly
growing lung carcinomas is, however, not quite
hopeless as there are a few 5 year survivors
even in the small cell anaplastic group.
HEIMILDASKRÁ
1. Þórarinsson, Hjalti: Læknablaðið 1962, 79-
93.
2. Ringertz, N. (Ed.): Cancer Incidence in
Finland, Iceland, Norway and Sweden: Acta
path. Microbiology Scand. Section A, suppl.
224, 1971, p. 12.
3. Ochsner, A., Ochsner, A. Jr., H’Doubler, C.
and Blalock, J.: Bronchogenic Carcinoma:
Diseases Of The Chest, Volume XXXVII,
January 1960.
4. Thompson, V.C.: Tumores Of The Lung:
Clinical Surgery 5, London Butterworth
1965 (p. 130-131).
5. Sterling, T. D.: A Critical Reassesment of
the Evidence Bearing on Smoking as a
Cause of Lung Cancer: AJPH September
1965, Vol. 65, no. 9, p. 939-953.
6. Thorarinson, H.: Carcinoma of the lung in
Iceland: Scand. J. Thor. Cardiovasc. Surg.
3:31-38, 1969.
7. Surgical Diseases of the Chest: Edited by
Brian Blades, M.D. The C.V. Mosby Com-
pany 1961, St. Louis, p. 150-167.
8. Fréttabréf um heilbrigðismál, nr. 5, april
1950.
9. Jónsson, Björn L.: Reykingar barna i
Reykjavík: Heilbrigt líf, 1963: 16:35.
10. Sigurðsson, Jón: Reykingavenjur barna og
unglinga í Reykjavík: Frá borgarlæknis-
embættinu i Reykjavík, ágúst 1975.
11. Guðmundsson, H., Björnsson, O.J., Ólafsson,
Ó.: Könnun á tóbaksneyslu Islendinga árin
1960 til 1975: Heilbrigðismál, rit nr. 2, 1975.
12. Shields, T.W. and Higgins, G.A. Jr. (1974):
Minimal Pulmonary Resection in Treatment
of Carcinoma of the Lung: Archives of
Surgery, 108, 420.
13. le Roux, B.T. (1972): Management of Bron-
chial Carcinoma by Segmental Resection:
Thorax, 27, 70.
14. Jensik, R.J., Faber, L.P., Milloy, F.J. and
Monson, D.O. (1973): Segmental Resection
for Lung Cancer: Journal of Thoracic and
Cardiovascular Surgery 66, 563.
15. Jensik, R.J., Penfield, F. and Kittle, C.F.:
Segmental Resection for Bronchogenic Car-
cinoma: The Annals of Thoracic Surgery,
vol. 28, 5, 1969.
16. Myron J. Jacobson, Lloyd Sand, Robert, T.
Fox and Willian Lees: A Comparison of
Wedge and Segmental Resection of the
Lung: Thorax (1976 ) 31, 365.
17. Overholt, H.R., Neptune, W.B. and Ashraf,
M.M.: Primary Cancer of the Lung: The
Annals of Thoracic Surgery, vol. 20, no. 5,
1975.
18. Wilkins, W. Jr., Scannell, J.G. and Graver,
J.G.: Four Decades of Experience with Re-
sections for Bronchogenic Carcinoma at the
Massachusetts General Hospital: Th. J. of
Thoracic & Carcinoma at the Massachu-
setts General Hospital: Th. J. of Thoracic
& Cardiovasc. Surgery, vol. 76, 3, 1978.
19. Bennett, W. and Smith, R.A.: Segmental
Resection for Bronchogenic Carcinoma: A
Surgical Alternative for the Compromised
Patients: The Annals of Thoracic Surg., vol.
27, 2, 169-72, 1979.
20. Bergh, N.P. and Scherstén, T.: Broncho-
genic Carcinoma; A Follow-up Study of a
Surgically Treated Series with Special Re-
ference to the Prognostic Significance of