Locati Laura D, Guzzo Marco, Bossi Paolo, Massone Paolo P Brega, Conti Barbara, Fumagalli Elena, Bareggi Claudia, Cantù Giulio, Licitra Lisa
Medical Oncology Unit/Head and Neck Unit, Istituto Nazionale Tumori, via Venezian 1, 20133 Milan, Italy.
Oral Oncol. 2005 Oct;41(9):890-4. doi: 10.1016/j.oraloncology.2005.04.014.
To define the role of surgical management of lung metastases in ACC. Twenty ACC patients referred to lung metastasectomy were retrospectively reviewed. Twenty-six operations were performed; at the first metastasectomy, a resection with clear margins (R0) was achieved in 11 patients (55%), 3 are alive and well. Four out of 9 patients with residual disease (R2) are still alive. Median survival after metastasectomy was 78 and 52 months for R0 and R2 (p=0.4); median freedom from progression (FFP) in R0 and R2 groups was 30 and 15 months (p=0.2), respectively. A better outcome was obtained for patients with a disease-free interval 36 months and 6 metastases and bilateral involvement were critical in achieving a R0 intervention. Lung metastasectomy provided a prolonged FFP in a high selected subset of patients with ACC. However, if this could be translated into a survival benefit, it is still to be demonstrated.
为明确手术治疗在肾上腺皮质癌（ACC）肺转移中的作用。对20例接受肺转移瘤切除术的ACC患者进行回顾性分析。共实施了26例手术；首次转移瘤切除时，11例患者（55%）实现了切缘阴性（R0）切除，其中3例存活且状况良好。9例有残留病灶（R2）的患者中有4例仍存活。R0和R2患者转移瘤切除术后的中位生存期分别为78个月和52个月（p = 0.4）；R0和R2组的中位无进展生存期（FFP）分别为30个月和15个月（p = 0.2）。无病生存期≥36个月的患者预后较好，转移灶数量≥6个及双侧受累对实现R0切除至关重要。肺转移瘤切除术在高度选择的ACC患者亚组中延长了FFP。然而，这是否能转化为生存获益仍有待证实。
