Koike Teruaki, Yamato Yasushi, Yoshiya Katsuo, Shimoyama Takehiko, Suzuki Ryuta
Division of Chest Surgery, Niigata Cancer Center Hospital, Niigata, Japan.
J Thorac Cardiovasc Surg. 2003 Apr;125(4):924-8. doi: 10.1067/mtc.2003.156.
The present study was undertaken to demonstrate that limited pulmonary resection for peripheral small-sized lung cancer yields outcomes not inferior to those of lobectomy.
During the 9-year period from 1992 to 2000, patients with cT1 N0 M0 peripheral non-small cell lung cancer whose maximum tumor diameter was 2 cm or less on diagnostic imaging and in whom lobectomy was determined to be feasible were treated with limited resection if the patient consented to the procedure and with lobectomy if consent to limited resection was not obtained. The survival and clinical outcome of the patients whose tumors were postoperatively staged as pT1 N0 M0 were compared between the limited resection group (n = 74) and the lobectomy group (n = 159).
The limited resection group consisted of 60 patients treated with segmentectomy and 14 patients treated with wedge resection. Among patients followed up for a mean period of 52 months after the operation, neither the 3-year nor 5-year survivals differed significantly between the limited resection group (3-year survival, 94.0%; 5-year survival, 89.1%) and the lobectomy group (3-year survival, 97.0%; 5-year survival, 90.1%). Postoperative tumor recurrence was noted in 5 patients after limited resection and in 9 patients after lobectomy, and the difference in the incidence of postoperative recurrence between the 2 groups was not significant.
The results of this study indicate that in patients with peripheral T1 N0 M0 non-small cell lung cancer whose maximum tumor diameter was 2 cm or less, the outcome of limited pulmonary resection is comparable with that of pulmonary lobectomy.
本研究旨在证明，对于周围型小肺癌行有限肺切除术的疗效不低于肺叶切除术。
在1992年至2000年的9年期间，对于经诊断性影像学检查最大肿瘤直径为2 cm或更小、且判定可行肺叶切除术的cT1N0M0周围型非小细胞肺癌患者，如果患者同意该手术则行有限切除术，如果未获得有限切除术的同意则行肺叶切除术。对术后分期为pT1N0M0的患者，比较有限切除组（n = 74）和肺叶切除组（n = 159）的生存情况和临床结局。
有限切除组包括60例行肺段切除术的患者和14例行楔形切除术的患者。在术后平均随访52个月的患者中，有限切除组（3年生存率94.0%；5年生存率89.1%）和肺叶切除组（3年生存率97.0%；5年生存率90.1%）的3年和5年生存率均无显著差异。有限切除术后有5例患者出现肿瘤复发，肺叶切除术后有9例患者出现肿瘤复发，两组术后复发率的差异无统计学意义。
本研究结果表明，对于最大肿瘤直径为2 cm或更小的周围型T1N0M0非小细胞肺癌患者，有限肺切除术的疗效与肺叶切除术相当。
