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August 1974

Bronchial Carcinoma Treated by Adjuvant Cancer Chemotherapy

Author Affiliations

From the Department of Surgery, Northwestern University Medical School, and the Surgical Service, Veterans Administration Research Hospital, Chicago (Dr. Shields); National Research Council, Washington, DC (Dr. Robinette and Mr. Keehn).

Arch Surg. 1974;109(2):329-333. doi:10.1001/archsurg.1974.01360020189037

Four prospective randomized trials were undertaken to evaluate single-drug chemotherapy after resection of bronchial carcinoma in men. The drugs studied were mechlorethamine hydrochloride, cyclophosphamide, and methotrexate. A total of 2,348 curative resections were carried out; 1,172 patients received adjuvant therapy after the resection and 1,176 underwent operation alone. The accumulated five- and ten-year survival rates were 24.8% and 13.5%, respectively, for the treatment group and 26.2% and 16.3% for the control group. The differences were not significant. It is therefore apparent that single-drug adjuvant therapy is not beneficial in the management of patients who have undergone a curative resection of a bronchial carcinoma. Involvement of lymph nodes in the specimen was associated with a significantly poorer prognosis, but cell type, other than oat cell, appeared not to affect the prognosis when a curative resection had been carried out.