Watanabe T, Watanabe A, Obama T, Abe T, Kusajima K
2nd Department of Surgery, Sapporo Medical University, Sapporo, Japan.
Kyobu Geka. 2002 Jan;55(1):56-60.
Of 692 patients who underwent operations for primary lung carcinoma between January 1980 and August 2001, 21 (3.0%) were considered to have a second primary lung carcinoma, which was synchronous in 14 cases (2.0%) and metachronous in 7 cases (1.0%). Five-year survival rate for patients with synchronous and metachronous disease from initial treatment of carcinoma were 66.7% and 100%, respectively. Survival after the development of a metachronous lesion was 80.0% at 5 years. Eight of the synchronous second tumors (57%) were detected by preoperative radiography or bronchoscopy, and 3 (21%) were detected during the operation. Adenocarcinoma comprised 81% of all multiple primary lung carcinomas, 86% of synchronous carcinomas and 57% of metachronous carcinomas. It is important to carefully examine a synchronous lesion before and during the operation of a primary lung carcinoma and to perform close follow-up surveillance for early detection of a metachronous lesion. The outcomes of surgical treatment for either synchronous or metachronous multiple primary lung carcinomas are satisfactory. Precise staging is important for the treatment of multiple lung carcinomas, and an aggressive surgical approach should be considered for early-stage carcinomas.
在1980年1月至2001年8月期间接受原发性肺癌手术的692例患者中,21例(3.0%)被认为患有第二原发性肺癌,其中14例(2.0%)为同时性,7例(1.0%)为异时性。从最初治疗癌症起,同时性和异时性疾病患者的5年生存率分别为66.7%和100%。异时性病变出现后的5年生存率为80.0%。8例(57%)同时性第二肿瘤通过术前影像学检查或支气管镜检查发现,3例(21%)在手术中发现。腺癌占所有多原发性肺癌的81%,同时性癌的86%,异时性癌的57%。在原发性肺癌手术前和手术期间仔细检查同时性病变,并进行密切随访监测以早期发现异时性病变很重要。同时性或异时性多原发性肺癌的手术治疗结果令人满意。精确分期对多原发性肺癌的治疗很重要,对于早期癌症应考虑积极的手术方法。