Togashi K, Hirahara H, Sugawara M, Miyamura H, Satoh Y
Division of Thoracic Surgery, Nagaoka Red Cross Hospital, Nagaoka, Japan.
Kyobu Geka. 2002 May;55(5):383-7.
From 1986 to 2000, 42 patients (3.7%) underwent resection for intrathoracic recurrence or second primary lung cancer. Survival in 27 patients with recurrent diseases was 60% at 5 years and 35% at 10 years compared with 65% at 5 and 10 years for 15 patients with metachronous lung cancers morphologically. Ten patients had the second operation less than 2 years since the first operation, 19 patients between 2 and 5 years, and 13 patients more than 5 years, while these 5-year survivals were 72%, 53%, 67% respectively. At the first operation lobectomy was performed in 39 patients (93%), wedge resection or segmentectomy in 3. The reoperation was 14 lobectomy or completion pneumonectomy, 24 wedge or segmentectomy (57%), and 4 other procedures, while these 5-year survivals were 35%, 73%, and 100% respectively. The 5-year survival was 78% for 27 patients with stage I disease and 26% for 10 patients with stage III disease at the first operation, compared with 55% for 30 patients with stage I and 53% for 9 patients with stage III at the reoperation. These data suggest that limited resection is recommended for intrathoracic recurrent diseases and metachronous multiple lung cancers whenever possible.
1986年至2000年期间，42例患者（3.7%）因胸内复发或第二原发性肺癌接受了切除术。27例复发性疾病患者的5年生存率为60%，10年生存率为35%，而15例异时性肺癌患者的5年和10年生存率分别为65%。10例患者在第一次手术后不到2年进行了第二次手术，19例在2至5年之间，13例超过5年，而这些患者的5年生存率分别为72%、53%、67%。第一次手术时，39例患者（93%）接受了肺叶切除术，3例接受了楔形切除术或肺段切除术。再次手术时，14例为肺叶切除术或全肺切除术，24例为楔形或肺段切除术（57%），4例为其他手术，而这些患者的5年生存率分别为35%、73%和100%。第一次手术时，27例I期疾病患者的5年生存率为78%，10例III期疾病患者的5年生存率为26%，而再次手术时，30例I期患者的5年生存率为55%，9例III期患者的5年生存率为53%。这些数据表明，对于胸内复发性疾病和异时性多发性肺癌，尽可能推荐进行局限性切除术。
