Bereder J M, Mouroux J, Benchimol D, Bernard J L, Richelme H
Service de Chirurgie Abdominale et Thoracique, Hôpital Pasteur, Nice.
Ann Chir. 1991;45(8):679-82.
The aim of this study was to determine immediate and long term prognostic factors after resection of stage III lung cancer. From 1981 to 1987, 188 consecutive patients (136 stage III A and 52 stage III B) underwent resection of a primary lung cancer. Mortality (5.8 per cent) and morbidity were not influenced by age of the patient, the type of procedure (lobectomy or pneumonectomy) or the stage A or B of the cancer. But mortality was significantly increased by alteration of four ventilatory parameters. Actuarial survival was significantly better for stage III A (56%, 34 or 7 at 1, 2 and 5 years) than for stage III B (35, 18, 0 respectively). Survival was also influenced by: the quality of the resection: 15 months median survival if curative, 5 months if palliative; the tumour volume: 65%, 47, 18 at 1, 2 and 5 years if the diameter of the tumour was less than 5 cm, and 49, 31, 0 respectively if the diameter was greater than 5 cm. The authors conclude that identification of these factors is determinant to discuss prognosis and to plan treatment.
本研究的目的是确定Ⅲ期肺癌切除术后的近期和长期预后因素。1981年至1987年，188例连续的原发性肺癌患者（136例ⅢA期和52例ⅢB期）接受了肺癌切除术。死亡率（5.8%）和发病率不受患者年龄、手术类型（肺叶切除术或全肺切除术）或癌症A期或B期的影响。但四项通气参数的改变会显著增加死亡率。ⅢA期患者的精算生存率（1年、2年和5年分别为56%、34%或7%）明显优于ⅢB期患者（分别为35%、18%、0）。生存率还受以下因素影响：切除质量：根治性切除的中位生存期为15个月，姑息性切除为5个月；肿瘤体积：肿瘤直径小于5 cm时，1年、2年和5年生存率分别为65%、47%、18%，直径大于5 cm时分别为49%、31%、0。作者得出结论，识别这些因素对于讨论预后和制定治疗计划具有决定性意义。
