Shimizu J, Watanabe Y, Oda M, Hayashi Y, Watanabe S, Tatsuzawa Y, Iwa T
Department of Surgery, Kanazawa University School of Medicine.
Kyobu Geka. 1991 Jan;44(1):42-6.
This report analyzes the operative indication for the small lesion of advanced lung cancer. The subjects consisted of 25 patients with T1N2 lung cancer, one T1N3, four T1M1 and five small lung cancer lesion with dissemination, which was regarded as the small lesion of advanced lung cancer. The cumulative 5-year survival rate after operation for 25 patients with T1N2 lesion was 30.6%. Of 25 patients, 18 were selected patients who underwent a curative operation with a 5-year survival of 37.0%. In the remaining 7 patients, who underwent a non-curative operation, 5-year survival was 0%. As to mediastinal lymph node involvement, it is possible that metastasis to more than two levels of mediastinal lymph nodes or to the upper mediastinal lymph nodes (#1-3) are poor prognostic factors in T1N2 lesion. Another group except T1N2 could not be the comparative materials because they were much fewer in number. But T4 cases associated with small lung cancer lesion with dissemination and T1M1 cases associated with intrapulmonary metastasis encountered at thoracotomy could be expected to have a long-term survival. We conclude that T1N2 patients with metastasis to within one level of mediastinal lymph node, which will possibly have a curative operation, is a proper operative indication for the small lesion of advanced lung cancer.
本报告分析了晚期肺癌小病灶的手术指征。研究对象包括25例T1N2肺癌患者、1例T1N3患者、4例T1M1患者以及5例伴有播散的小肺癌病灶患者（后者被视为晚期肺癌小病灶）。25例T1N2病灶患者术后的累积5年生存率为30.6%。在这25例患者中，18例为接受根治性手术的入选患者，其5年生存率为37.0%。其余7例接受非根治性手术的患者，5年生存率为0%。至于纵隔淋巴结受累情况，对于T1N2病灶而言，纵隔淋巴结转移至两个以上水平或上纵隔淋巴结（#1 - 3）可能是不良预后因素。除T1N2外的另一组病例因数量过少无法作为对照材料。但伴有播散的小肺癌病灶相关的T4病例以及开胸手术中遇到的伴有肺内转移的T1M1病例有望获得长期生存。我们得出结论，T1N2患者若纵隔淋巴结转移至一个水平以内，且可能接受根治性手术，则是晚期肺癌小病灶合适的手术指征。
