Haro Akira, Yano Tokujiro, Yoshida Tsukihisa, Ito Kensaku, Morodomi Yosuke, Shoji Fumihiro, Nakashima Torahiko, Maehara Yoshihiko
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Interact Cardiovasc Thorac Surg. 2010 May;10(5):700-3. doi: 10.1510/icvts.2009.219766. Epub 2010 Feb 1.
There have been only a few reports about a surgical resection of pulmonary metastasis from malignant head and neck tumor. Here we investigate the survival after a pulmonary metastasectomy, and discuss the prognostic factors. We retrospectively reviewed 25 patients who underwent a pulmonary metastasectomy from malignant head and neck tumor at Kyushu University Hospital from 1981 through 2008. We assessed the five year overall survival by the Kaplan-Meier method and the log-rank (Mantel-Cox) test using the Stat View software program. The three- or five-year overall survival after a metastasectomy was 53.3% and 50.0%, respectively. We investigated the clinico-pathological prognostic factors including gender, age, histology, disease free interval, number or size of pulmonary metastatic tumors, and the operative procedure. Both age (older than 60 years) (P=0.0189) and pulmonary metastases from squamous cell carcinomas in either oral cavity or pharyngeal region (P=0.0002) were identified to be adverse prognostic factors. To obtain a long survival, a positive surgical resection is considered to be an effective and standard treatment for pulmonary metastasis from malignant head and neck tumor. It is also necessary, however, to elucidate fully the primary site and histology of such pulmonary metastasis.
关于恶性头颈部肿瘤肺转移灶的手术切除，仅有少数报道。在此，我们研究肺转移瘤切除术后的生存率，并探讨预后因素。我们回顾性分析了1981年至2008年在九州大学医院接受恶性头颈部肿瘤肺转移瘤切除术的25例患者。我们使用Stat View软件程序，通过Kaplan-Meier法和对数秩（Mantel-Cox）检验评估五年总生存率。转移瘤切除术后三年和五年的总生存率分别为53.3%和50.0%。我们研究了临床病理预后因素，包括性别、年龄、组织学类型、无病间期、肺转移瘤的数量或大小以及手术方式。年龄（大于60岁）（P = 0.0189）和口腔或咽区鳞状细胞癌的肺转移（P = 0.0002）均被确定为不良预后因素。为了获得长期生存，积极的手术切除被认为是治疗恶性头颈部肿瘤肺转移的有效且标准的方法。然而，充分阐明此类肺转移的原发部位和组织学类型也是必要的。
