Ohkubo T, Okayasu T, Hashimoto M, Shiiya N, Konishi K, Motohara T, Katoh H
Second Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
Kyobu Geka. 2000 Feb;53(2):127-31.
In this study, we defined a solitary lung nodle in the same histology which could be traced its' origin from carcinoma in situ or was found over than two years' follow up as a second primary lung cancer. These cases were excluded. Eighteen cases underwent second surgery for intrathoracic recurrence. Fourteen cases were male and four cases were female. Their ages ranged from 23 to 75 (average 59.6) years. The histology were adenocarcinoma in 9 cases, squamouscarcinoma in 7, adenosquamous carcinoma in 1, large cell carcinoma in 1. The initial surgical procedures were lobectomy in 17, partial resection in 1. The initial stage were I in 13, II in 2, IIIA in 1. Pulmonary recurrence were found in 10, bronchial stump recurrence were found in 4, pulmonary hilus lymph node recurrence were found in 2, mediastinal lymph node recurrence were found in 2, pulmonary stump recurrence was found in 1. The second surgical procedures were completion pneumonectomy in 7, completion lobectomy in 1, lobectomy with segmentectomy in 1, segmentectomy or partial resection in 7, mediastinal dissection in 2. The overall 5-year survival rate of the patients with recurrence after reoperation was 31.8%. An aggressive surgical approach for recurrent lung cancer should be recommended.
在本研究中,我们将同一组织学类型的孤立性肺结节定义为可追溯其起源于原位癌或在两年以上随访中发现的第二原发性肺癌,这些病例被排除在外。18例患者因胸内复发接受了二次手术。其中男性14例,女性4例。年龄范围为23至75岁(平均59.6岁)。组织学类型为腺癌9例,鳞癌7例,腺鳞癌1例,大细胞癌1例。初次手术方式为肺叶切除术17例,部分切除术1例。初始分期为I期13例,II期2例,IIIA期1例。发现肺复发10例,支气管残端复发4例,肺门淋巴结复发2例,纵隔淋巴结复发2例,肺残端复发1例。二次手术方式为全肺切除术7例,全肺叶切除术1例,肺叶切除加段切除术1例,段切除术或部分切除术7例,纵隔清扫术2例。再次手术后复发患者的总体5年生存率为31.8%。对于复发性肺癌,应推荐积极的手术方法。