Bronchogenic carcinoma: the role of the bronchoscopist in its early diagnosis

Our plain-English summary of Bronchogenic carcinoma: the role of the bronchoscopist in its early diagnosis, by A. Ochsner (1949).

The study

• Author: A. Ochsner
• Published: Read by invitation at the Fifty-seventh Annual Meeting of the American Laryngological, Rhinological and Otological Society, Inc., New Orleans, La., April 1951(?); pp. 700-711 (1949)
• Type of article: Conference paper
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This article is the text of an invited address to a meeting of ear, nose and throat specialists in New Orleans about lung cancer (bronchogenic carcinoma) and its early diagnosis. It does not mention asbestos. The author said they were convinced that the rise in lung cancer was due to increased cigarette use. This was the author's opinion, not something this series tested. The author described a series of patients the author's group had seen; the total number is unreadable in the scan. In this series, 90 per cent were men, and the upper lobes of the lungs were involved in 56 per cent. Bronchoscopy gave a positive diagnosis in only 37 per cent of cases. Examining cells in bronchial secretions or sputum gave one in 68 per cent. Of 372 patients who had a whole lung removed (pneumonectomy), 20 per cent died in hospital. The average delay from first symptom to the start of definitive curative treatment was 8.7 months. Five-year survival was six per cent for the entire series and 15.2 per cent for patients who had a resection. The author concluded that the only curative treatment was radical removal of the involved lung and regional lymph nodes.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Invited lecture (published address) describing the author's own clinical case series of lung cancer patients; not a formal study
• Who was studied: Patients with proven bronchogenic (lung) cancer seen by the author's group in New Orleans, including private patients and Charity Hospital patients. The total number is garbled in the scan; 639 were considered operable.
• Exposure: Cigarette smoking, discussed as the author's view of the cause of the rise in lung cancer; smoking was not measured for individual patients. Asbestos is not mentioned.
• Main results:
  • 90 per cent of the patients in the series were men
  • Of all cases, almost 53 per cent were epidermoid, 28 per cent undifferentiated and 19 per cent adenocarcinoma. In women, 22 per cent were epidermoid, 28 per cent undifferentiated and 50 per cent adenocarcinoma.
  • The upper lobes were involved in 56 per cent of cases (27 per cent right upper lobe, 29 per cent left upper lobe)
  • Bronchoscopy gave a positive diagnosis in only 37 per cent of cases
  • Cytological examination of bronchial secretions or sputum gave a positive diagnosis in 68 per cent of cases
  • 372 patients had a pneumonectomy, with a 20 per cent hospital mortality. Pneumonectomy mortality was 48 per cent before 1941, 20 per cent from 1942 to 1946 and 18 per cent in 1947 to 1952.
  • The average delay from onset of symptoms to the institution of definite curative therapy was 8.7 months in the entire series; the physician was responsible for 5.5 months of it
  • Five-year survival was six per cent for the entire series and 15.2 per cent for patients who had a resection. It was 7.2 per cent after palliative resection and 36.2 per cent when the lesion was apparently limited to the lung. No patient without resection survived four years.
• The authors' conclusion: The author concluded that the only curative treatment of bronchogenic carcinoma is radical removal of the involved lung and the regional lymph nodes, and stressed early diagnosis

Topics

Medical terms in this study, explained in our Lexicon: Bronchogenic Carcinoma, Lung Cancer, Bronchoscopy, Sputum, Pneumonectomy.

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