Primary Carcinoma of the Lung

Our plain-English summary of Primary Carcinoma of the Lung, by A. Ochsner, M. DeBakey (1941).

The study

• Authors: A. Ochsner, M. DeBakey
• Published: New Orleans Medical and Surgical Journal 93(8):387-395 February (1941)
• Type of article: Journal article
• 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 1941 article was a general review of primary carcinoma of the lung, presented to the Louisiana State Medical Society. It did not discuss asbestos. The authors surveyed published reports on how often the disease occurred, how it looked under the microscope, its symptoms, diagnosis and treatment. They added figures from case series they had collected from the literature and from their own surgical patients. In 8,675 collected cases, 78.9 per cent were males. In 4,307 collected cases, about 60 per cent were aged 40 to 60. The authors stated that there was no definite explanation for the rising incidence. They briefly reviewed proposed explanations, including irritating gases, radioactive emanations in the Schneeberg and Joachimsthal mines, silicosis (on which opinion was divided) and tobacco. They reported finding a significant relationship between rising lung cancer in the United States and rising tobacco production. Across their 19 operations removing a lung, mortality was 47.3 per cent. The authors concluded that lung cancer was definitely and steadily increasing, that radiation was of little or no value, and that the only curative treatment was surgical removal of the involved lung.

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: Narrative review of the literature on primary lung carcinoma, with summary figures from case series the authors collected from the literature and from their own surgical cases; read before a medical society meeting
• Who was studied: Published reports and collected case series of primary lung carcinoma from many countries, plus the authors' own 19 pneumonectomy patients in New Orleans
• Exposure: No asbestos exposure was studied or discussed in the text. The authors said there was no definite explanation for the rising incidence. Proposed explanations they reviewed included irritating gases, radioactive emanations in the Schneeberg and Joachimsthal mines, pneumoconiosis and silicosis (disputed), and tobacco.
• Main results:
  • In a collected series of 8,675 lung cancer cases, 78.9 per cent were males and 21 per cent were females
  • In 4,307 collected cases, about 60 per cent occurred between ages 40 and 60, about 80 per cent between 40 and 70, and 10.7 per cent between 30 and 40
  • In 4,732 collected cases, the right lung was involved in 58.3 per cent and the left in 41.6 per cent
  • In 2,679 collected cases, spread to the liver was found in 33.4 per cent, bones 20.4 per cent, adrenals 17.6 per cent, kidneys 16 per cent and brain 14.6 per cent
  • The authors reported a significant relationship between the increased incidence of lung cancer in the United States and increased tobacco production
  • Of the authors' 19 pneumonectomy patients, mortality was 47.3 per cent. In the discussion, the first-named author reported that ten left the hospital, two died on the table and seven died during convalescence in hospital, and that eight of the ten were still living.
• The authors' conclusion: The authors concluded that lung cancer incidence was definitely and steadily increasing. They also concluded that radiation therapy was of little or no value, that the only curative treatment was surgical removal of the involved lung, and that the disease should be suspected in every patient past forty with an unexplained cough that does not respond to therapy.

Topics

Medical terms in this study, explained in our Lexicon: Carcinoma, Silicosis, Lung Cancer.

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