Fujisawa T, Yamaguchi Y, Shiba M, Baba M, Yusa T, Yamakawa H, Kimura H, Iwai N, Nomoto Y, Yamaguchi T
Department of Surgery, Chiba University School of Medicine, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Feb;28(2):210-5.
Surgical treatment and combined chemotherapy of non-small cell lung cancers during the last 10 years were analyzed. Overall 5 year survival rate of non-small cell lung cancer was 37% and those in stages I, II, IIIA and IIIB were 59%, 33%, 21% and 12%, respectively. Poor outcome in IIIA cases depended strongly on surgical respectability, however, adenocarcinoma cases depended more on the T factor and squamous cell carcinoma depended more on the N factor. IIIA cases, even though resected curatively, showed 10-20% local recurrence, indicating the importance of further improvement of the surgical procedure. In the cases with absolutely non-curative resection tumor remained in mediastinal lymph nodes or organs adjacent to the mediastinum, indicating the necessity of extended combined resection including contralateral mediastinal lymph nodes or organs adjacent to the mediastinum for better results of surgical treatment. Preoperative chemotherapy for the suppression of local recurrence and distant metastasis was significant only in very limited circumstances.
分析了过去10年非小细胞肺癌的外科治疗及联合化疗情况。非小细胞肺癌的总体5年生存率为37%，I期、II期、IIIA期和IIIB期的5年生存率分别为59%、33%、21%和12%。IIIA期病例预后较差很大程度上取决于手术可切除性，然而，腺癌病例更多取决于T因素，鳞状细胞癌更多取决于N因素。IIIA期病例即使根治性切除后仍有10% - 20%的局部复发，这表明进一步改进手术操作的重要性。在绝对无法根治性切除的病例中，肿瘤残留于纵隔淋巴结或纵隔相邻器官，这表明为了获得更好的手术治疗效果，有必要进行扩大联合切除，包括对侧纵隔淋巴结或纵隔相邻器官。术前化疗对抑制局部复发和远处转移仅在非常有限的情况下有意义。
