摘要
分析中山医科大学肿瘤医院１９７０年１月１日～１９９３年１２月３１日间１８０６例非小细胞肺癌（ＮＳＣＬＣ）外科治疗中对局部晚期ＮＳＣＬＣ的特殊处理模式。１）关于ＮＳＣＬＣ的减量性手术问题。用Ｋａｐｌａｎ－Ｍｅｉｅｒ分析比较２４４例肺癌减量术及同期３６４例剖胸探查术的累量生存率和影响因素。结果显示，非小细胞肺癌减量术的１、３、５年累量生存率分别为５６９％、２０６％和１７５％；探查术为４１１％、７８％和５３％。因此，肺癌的减量性手术应积极提倡，应列为重要治疗手段之一，配合术后的放、化疗，能有效地提高病人的生存率。２）关于ＮＳＣＬＣ支气管残端阳性的问题。７１例术后支气管残端阳性的肺癌病人的１、３、５和１０年累积生存率分别为５９５％、３２４％、２５０％和１９３％，低于根治术组。最佳的治疗方式在是纵隔淋巴结清扫的基础上辅以术后放射治疗。３）关于ＮＳＣＬＣ的多次手术问题。复发ＮＳＣＬＣ的再次手术，１、３和５年累积生存率可达５５％、１７％和１７％，应认为是目前肺癌术后复发的最有效治疗方法之一。４）对双肺同期发生的孤立或多发肿瘤，采用一期切除的方法。
Some special problems of surgery for 1806 patients with operated non-small cell lung cancer from Jan.1,1970 to Dce.31,1993 were discussed. 1).About debulking operation for lung cancer.The cumulative survival and its influencing factors were analyzed and compared by the Kaplan-Meier in 244 patients received debulking operation and 364 received thoracotomy.The 1,3 and 5-year cumulative survival of patients treated with debulking operation was 56 9%,20 6% and 17 5% respectively. While those received thoracotomy was 41 1%,7 8% and 5 3%,respectively.Tumor debulking operation is an important treatment for stage Ⅲ、Ⅳ non-small cell lung cancer.With postoperative adjuvant chemoradiotherapy better survival can be achieved.2) About postoperative positive cancer cell in bronchial stump pathologically.The 1,3,5 and 10-year cumulative survivals of 71 patients with positive in bronchial stump were 59 5%,32 4%,25 0% and 19 3%, respectively.It is lower than the group of curative operation.The optimal treatment was postoperative radiation based on mediastinal lymph node dissection.3) About multi-operations for advanced NSCLC.The 1,3 and 5-year cumulative survival rates for recurrent NSCLC were 55%,17% and 17%, respectively.The multi-operations for NSCLC are still an effective method for recurrence and metastasis or second primary lung caner.4) The 5-year survival of 28.6(2/7) could be achieved by simultaneously resection for bilateral solid or multiple lung cancer.
出处
《暨南大学学报（自然科学与医学版）》
CAS
CSCD
1998年第6期74-75,共2页
Journal of Jinan University(Natural Science & Medicine Edition)
关键词
非小细胞肺癌
减量性手术
生存率
肺癌
non small cell lung cancer
\ debulking operation
survival rate
