Mouroux J, Bereder J M, Benchimol D, Bernard J L, Bourgeon A, Richelme H
Service de Chirurgie abdominale et thoracique, Nice.
Chirurgie. 1990;116(1):53-8; discussion 58-9.
From January 1979 to December 1988, 18 patients with pulmonary metastases from colorectal cancers were operated in our division. This series included 11 men and 7 women (average age 57 years). The primary cancer was colic in 6 cases and rectal in 12. In 3 cases, the metastases were synchronous and discovered during the initial assessment. In 15 cases, they were metachronous, without symptoms in 12 cases and symptomatic in 3. These metastases were single in 14 cases, multiple in 3, bilateral in 1. They were peripheral in 15 cases. The histological diagnosis was obtained preoperatively in 5 cases (27.7%). The procedures uses were lobectomy for 11 patients, segmentectomy for 1, wedge resection for 10. Postoperative chemotherapy was given to 7 patients. Benign complications occurred in 2 cases during the postoperative period. No perioperative death was noted. One patient was lost to follow-up without recurrence after 1 year, 6 patients died from neoplastic evolution 4, 8, 15, 17, 22 and 28 months after being operated. In May 1989, 11 patients were still living: -2 scheduled for the excision of a contralateral lesion, -2 with pulmonary recurrence. 7 patients were alive without recurrence 12, 14, 17, 46, 52, 68 and 108 months after being operated. The probability of occurrence of pulmonary metastases in the evolution of colorectal cancer is estimated between 20 and 50%. Only 1% of the patients can be treated surgically. When screening these lesions, one must bear in mind that their appearance is sometimes quite delayed, and often asymptomatic. The repeated use of tracers is necessary but not sufficient.(ABSTRACT TRUNCATED AT 250 WORDS)
1979年1月至1988年12月,我科对18例结直肠癌肺转移患者实施了手术。该组包括11名男性和7名女性(平均年龄57岁)。原发性癌位于结肠6例,直肠12例。3例转移灶为同时性,在初次评估时发现。15例为异时性,其中12例无症状,3例有症状。这些转移灶14例为单发,3例为多发,1例为双侧。15例位于周边部位。5例(27.7%)术前获得了组织学诊断。所采用的手术方式为肺叶切除术11例,肺段切除术1例,楔形切除术10例。7例患者术后接受了化疗。术后发生良性并发症2例。围手术期无死亡病例。1例患者术后1年失访,无复发。6例患者术后4、8、15、17、22和28个月因肿瘤进展死亡。1989年5月,11例患者仍存活:2例计划切除对侧病变,2例有肺复发。7例患者术后12、14、17、46、52、68和108个月存活且无复发。结直肠癌进展过程中发生肺转移的概率估计在20%至50%之间。只有1%的患者可接受手术治疗。筛查这些病灶时,必须牢记其出现有时相当延迟,且常无症状。反复使用示踪剂是必要的,但并不充分。(摘要截取自250字)