Kawashima O, Sugano M, Kakegawa S, Kamiyoshihara M, Shimizu K, Otani Y, Morishita Y
Department of Thoracic Surgery, National Nishigunma Hospital, Shibukawa, Japan.
Kyobu Geka. 2004 Jan;57(1):56-60.
Recently the diagnosis of peripheral small-sized lung cancers has increased with the development of computed tomography. The vast majority of them are adenocarcinoma, whereas squamous cell carcinoma is rare. From 1981 to 2002, 1,054 patients underwent pulmonary resection for primary lung cancer in National Nishigunma Hospital. Among of them, 17 patients with peripheral small-sized (2 cm or less) squamous cell carcinoma underwent lobectomy and systemic nodal dissection were retrospectively reviewed. These were 15 men and 2 women, with a mean age of 68 years (range, 56-75). Regarding the pathologic stage, 15 patients were classified in stage IA, 1 in IIA, and 1 in IIIA. Among of them, only 1 patient with n 2 disease died of cancer at 17 months after surgery. Overall 5-year and 10-year survival rates of this disease were 84.4% and 73.8%, respectively. Based on the present data, we conclude that mediastinal nodal dissection would be unnecessary in the patients with peripheral small-sized squamous cell carcinoma of the lung.
近年来,随着计算机断层扫描技术的发展,周围型小肺癌的诊断率有所提高。其中绝大多数为腺癌,而鳞状细胞癌较为罕见。1981年至2002年期间,在日本群马县西部医院,有1054例患者因原发性肺癌接受了肺切除术。其中,对17例周围型小(2 cm或更小)鳞状细胞癌患者进行了肺叶切除术和系统性淋巴结清扫术,并进行了回顾性研究。这些患者中男性15例,女性2例,平均年龄68岁(范围56 - 75岁)。在病理分期方面,15例患者为IA期,1例为IIA期,1例为IIIA期。其中,只有1例伴有N2疾病的患者在术后17个月死于癌症。该疾病的总体5年和10年生存率分别为84.4%和73.8%。基于目前的数据,我们得出结论,对于周围型小肺鳞状细胞癌患者,纵隔淋巴结清扫术可能是不必要的。