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Staging of inoperable patients with bronchogenic carcinoma with special reference to bone marrow examination and peritoneoscopy

Staging of bronchogenic carcinoma is important for optimal treatment. The current studies establish the usefulness of exploring the site of distant metastases in patients who are already inoperable. Bone marrow examination from the posterior iliac crest performed in 150 consecutive patients revealed tumor involvement in 16.6%. The highest yield (46.4%) was obtained in small cell carcinoma of the lung. Peritoneoscopy and liver biopsy under vision were performed in 58 patients. The yield of positive findings was 2.1% in 47 patients with disease otherwise believed confined to the chest, and 27.2% in 11 patients with other established areas of dissemination. All these patients shown to have hepatic metastases had small cell carcinoma. Survival following treatment with chemotherapy in patients with bone marrow invasion was substantially longer for those with small cell carcinoma than with other cell types of bronchogenic carcinoma.