López L, López Pujol J, Varela A, Baamonde C, Socas L, Salvatierra A, Freixinet J, Cerezo F
Department of Thoracic Surgery, Hospital Universitario NTRA. SRA. Del Pino, Las Palmas de Gran Canaria, Spain.
Scand J Thorac Cardiovasc Surg. 1992;26(2):129-33. doi: 10.3109/14017439209099067.
Thirty-five patients who had undergone surgery for non-small cell bronchogenic carcinoma with isolated involvement of the chest wall were reviewed. The diagnosis was preoperatively suspected in 80% of cases. En-bloc resection of the invaded chest wall was performed in 25 cases and parietal pleurectomy in ten in which the pleura was easily dissectable from the costal plane. Of the eight patients with major complications in the early postoperative period, six, including the two who died perioperatively, had undergone en-block resection. The 5-year actuarial survival rate was 22% overall and 36% in the patients without lymph node involvement. No significant relationship between survival and type of operation or degree of chest wall invasion was found. Isolated involvement of the chest wall by non-small cell bronchogenic carcinoma does not necessarily contraindicate surgery with curative intent. Parietal pleurectomy is valid in selected cases. Long-term survival depends basically on node involvement.
回顾了35例因非小细胞支气管源性癌侵犯胸壁而接受手术的患者。80%的病例术前得到疑似诊断。25例行胸壁整块切除，10例胸膜易于从肋平面剥离者行胸膜外剥脱术。术后早期有8例发生严重并发症，其中6例（包括围手术期死亡的2例）接受了整块切除。总体5年精算生存率为22%，无淋巴结转移患者为36%。未发现生存率与手术方式或胸壁侵犯程度之间存在显著关系。非小细胞支气管源性癌孤立侵犯胸壁不一定是根治性手术的禁忌证。胸膜外剥脱术在部分病例中有效。长期生存主要取决于淋巴结转移情况。
