经正中胸骨切开术对右上叶非小细胞肺癌进行完整切除。

Complete resection via medial sternotomy for non-small cell lung cancer in the right upper lobe.

作者信息

Miyamoto Hideaki, Wang Zhiming, Fukai Ryuta, Futagawa Toshiro, Anami Yoichi, Yamazaki Akio, Morio Atsushi, Hata Enjo

机构信息

Department of General Thoracic Surgery, Juntendo University, School of Medicine, Tokyo, Japan.

出版信息

ANZ J Surg. 2005 Dec;75(12):1049-54. doi: 10.1111/j.1445-2197.2005.03614.x.

DOI:10.1111/j.1445-2197.2005.03614.x

PMID:16398809

Abstract

BACKGROUND

Right upper lobectomy with right cervical and bilateral mediastinal lymph node dissection via a median approach was performed for non-small cell lung cancer.

METHODS

From 1995 to 2003, 48 patients aged < or = 70 years underwent resection of cancer in the right upper lobe, including 26 with N0, four with N1 and 18 with N2 disease.

RESULTS

Metastases to the right cervical, highest mediastinal, pretracheal and bilateral tracheobronchial lymph nodes were frequent. There were no operative or hospital deaths. Preoperative accuracy of N-factor diagnosis was only 35.4%. The overall 5-year survival rate was 58.8%. The rate for C-N2 disease (n = 18) was 42.6%, and the rate for p-N2 disease (n = 7) and p-N3 disease (n = 13) was 57.1% and 0%, respectively, using the Kaplan-Meier method.

CONCLUSIONS

Patients without N3 disease have a good prognosis, and extended and systematic radical lymphadenectomy via median sternotomy improves the staging, and possibly the prognosis of pure N2 disease.

摘要

背景

对非小细胞肺癌患者采用正中入路行右上叶切除术并清扫右颈部及双侧纵隔淋巴结。

方法

1995年至2003年，48例年龄≤70岁的患者接受了右上叶癌切除术，其中N0期26例，N1期4例，N2期18例。

结果

右颈部、最高纵隔、气管前及双侧气管支气管淋巴结转移较为常见。无手术或医院死亡病例。N分期诊断的术前准确率仅为35.4%。总体5年生存率为58.8%。采用Kaplan-Meier法，C-N2期（n = 18）患者的生存率为42.6%，p-N2期（n = 7）和p-N3期（n = 13）患者的生存率分别为57.1%和0%。