Bonnette P
Chirurgie Thoracique, Hôpital Foch, 40, rue Worth, 92151 Suresnes, France.
Rev Mal Respir. 2011 Oct;28(8):960-6. doi: 10.1016/j.rmr.2011.01.014. Epub 2011 Oct 1.
Surgery is indicated for N1 non-small cell lung cancer and performed, with good results in some patients, when N2 disease is not diagnosed preoperatively "minimal N2". Following the publication of the "EORTC 08941" and "Intergroup 0139" trials, it remains debatable for patients with proven N2 disease. Good prognostic factors before treatment or post-induction favour surgery, which seems superior to radiochemotherapy if the operative risk is low (lobectomies, and some pneumonectomies). N3 status is a contraindication to surgery, except in some rare cases with a strong response to induction treatment.
手术适用于N1期非小细胞肺癌，当术前未诊断出N2期疾病（“微小N2”）时进行手术，部分患者会取得良好效果。在“欧洲癌症研究与治疗组织08941”和“肿瘤协作组0139”试验发表后，对于已证实为N2期疾病的患者，手术是否适用仍存在争议。治疗前或诱导治疗后的良好预后因素有利于手术，如果手术风险较低（肺叶切除术和一些全肺切除术），手术似乎优于放化疗。N3期是手术的禁忌症，但在一些对诱导治疗反应强烈的罕见情况下除外。
