Teramachi M, Miyamoto N, Sasaka T, Nakamura T, Kitamura F
Department of Thoracic Cardiovascular Surgery, Kochi Municipal Hospital.
Kyobu Geka. 1990 Dec;43(13):1043-5.
Eleven patients of T1N0M0 non-small cell lung cancer underwent relatively non-curative surgical resection without mediastinal lymph node dissection (the undissected group). The 5 year survival rate of this group was 70.7% and no significant difference in survival was found between the undissected group and the patients of T1N0M0 non-small cell lung cancer undergoing absolutely curative surgical resection (the dissected group). No patient died of pneumonia in the undissected group, while 4 aged patients in the dissected group died of pneumonia. This may suggest that mediastinal lymph node dissection is also injurious in distant period after surgery, especially in the aged patient. So "simple lobectomy" without mediastinal lymph node dissection may be considered as an elective procedure in the poor risk patient such as the aged, who has an early staged non-small cell lung cancer.
11例T1N0M0期非小细胞肺癌患者接受了相对非根治性手术切除，未进行纵隔淋巴结清扫（未清扫组）。该组5年生存率为70.7%，未清扫组与接受绝对根治性手术切除的T1N0M0期非小细胞肺癌患者（清扫组）之间在生存率上未发现显著差异。未清扫组无患者死于肺炎，而清扫组有4例老年患者死于肺炎。这可能表明纵隔淋巴结清扫在术后远期也有损害，尤其是对老年患者。因此，对于早期非小细胞肺癌的老年等高危患者，可考虑将不进行纵隔淋巴结清扫的“单纯肺叶切除术”作为一种选择性术式。
