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手术治疗肺类癌患者的长期预后和影响因素:我们机构 104 例患者的经验。

Long-term outcomes and prognostic factors of patients with surgically treated pulmonary carcinoid: our institutional experience with 104 patients.

机构信息

Department of Thoracic Surgery, Ataturk Training and Research Hospital for Chest Disease and Chest Surgery, Kecioren, Ankara, Turkey.

出版信息

Eur J Cardiothorac Surg. 2011 Apr;39(4):549-54. doi: 10.1016/j.ejcts.2010.08.010. Epub 2011 Feb 1.

Abstract

OBJECTIVE

Pulmonary carcinoid tumors are rare low-grade malignant neoplasms and constitute 2-5% of all lung tumors. In this study, we aimed to determine the clinical presentations, types of surgery, long-term treatment outcomes and survival rates of patients diagnosed with carcinoid tumor treated surgically in our clinic.

METHODS

Patients operated in our clinic between 1992 and 2008 with confirmed or suspected diagnoses of carcinoid tumors were included in our study. Patients' hospital records were retrospectively analyzed.

RESULTS

A total of 104 patients (age 19-71 years, mean 44±13 years, 2 SD) with pathologically confirmed carcinoid tumor were analyzed. A total of 84 patients (81%) were diagnosed as typical and the remaining 20 (19%) being atypical carcinoid tumor. As many as 24 patients (23%) were asymptomatic. The most frequent symptom was recurrent respiratory infection (35%). The most used surgical procedures were lobectomy (47%) and bilobectomy (16%). Mean postoperative follow-up period was 72 months (6-190 months). No surgery related mortality was noticed. As many as 15 (14%) patients died during the follow-up period. Overall 5- and 10-year survival rates were 89% and 72%, respectively. For typical carcinoid tumors, the 5- and 10-year survival rates were 92% and 83%, and for atypical carcinoids 73% and 46%, respectively (p<0.001).

CONCLUSIONS

In our study, we noticed histological subtype, stage of the disease and the type of surgery performed to be prognostic factors of carcinoid tumors. Atypical carcinoid tumors tend to be more metastatic and had worse prognosis when compared with typical carcinoid tumors. We conclude that surgery is the best treatment of choice for carcinoid tumors, especially parenchyma-sparing procedures, because of their good mid- and long-term survival rates.

摘要

目的

肺类癌肿瘤是罕见的低级别恶性肿瘤,占所有肺部肿瘤的 2-5%。本研究旨在确定在我院接受手术治疗的类癌肿瘤患者的临床表现、手术类型、长期治疗结果和生存率。

方法

我们纳入了 1992 年至 2008 年间在我院接受手术治疗且确诊或疑似患有类癌肿瘤的患者。回顾性分析患者的住院病历。

结果

共有 104 例(年龄 19-71 岁,平均 44±13 岁,2 个标准差)患者的病理诊断为类癌肿瘤。其中 84 例(81%)诊断为典型类癌,其余 20 例(19%)为非典型类癌。24 例(23%)患者无症状。最常见的症状是复发性呼吸道感染(35%)。最常用的手术方式为肺叶切除术(47%)和双肺叶切除术(16%)。平均术后随访时间为 72 个月(6-190 个月)。无手术相关死亡。随访期间共有 15 例(14%)患者死亡。总体 5 年和 10 年生存率分别为 89%和 72%。对于典型类癌,5 年和 10 年生存率分别为 92%和 83%,而非典型类癌为 73%和 46%(p<0.001)。

结论

在我们的研究中,我们注意到组织学亚型、疾病分期和手术类型是类癌肿瘤的预后因素。与典型类癌相比,非典型类癌往往更具转移性,预后更差。我们得出结论,手术是类癌肿瘤的最佳治疗选择,特别是保留肺实质的手术,因为它们具有良好的中、长期生存率。

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