Warner R, Ball S K, Dalton M L
Thoracic Surgery Service, Veterans Administration Medical Center, Jackson, MS.
South Med J. 1990 Jun;83(6):621-3, 633. doi: 10.1097/00007611-199006000-00006.
Chest wall invasion by bronchogenic carcinoma is found in 5% of all cases of pulmonary carcinoma. During the last 3 years, 11 cases of lung cancer with chest wall involvement have been encountered at the Jackson Veterans Administration Medical Center. We reviewed these cases to reassess the role of concomitant resection of the lung and chest wall. From this experience, we have concluded that (1) chest wall involvement is potentially curable; (2) chest wall resection adds little if any morbidity to the procedure; (3) resections of fewer than four ribs usually require only soft tissue coverage, without a prosthesis; (4) patients with squamous cell cancer have longer survival; (5) chest wall resection is highly effective in the relief of pain due to invasion of the chest wall; and (6) survival is greater than in other stage III lung carcinomas and is more closely related to nodal involvement than to chest wall invasion.
在所有肺癌病例中，5%的患者存在支气管源性癌侵犯胸壁的情况。在过去3年里，杰克逊退伍军人管理局医疗中心共收治了11例伴有胸壁受累的肺癌患者。我们对这些病例进行了回顾，以重新评估同期切除肺和胸壁的作用。基于此经验，我们得出以下结论：（1）胸壁受累有可能治愈；（2）胸壁切除对手术的发病率影响很小（如果有影响的话）；（3）切除少于四根肋骨通常仅需软组织覆盖，无需假体；（4）鳞状细胞癌患者的生存期更长；（5）胸壁切除对于缓解因胸壁侵犯引起的疼痛非常有效；（6）其生存率高于其他III期肺癌，且与淋巴结受累的关系比与胸壁侵犯的关系更为密切。
