Hamatake Daisuke, Yoshida Yasuhiro, Miyahara So, Yamashita Shin-ichi, Shiraishi Takeshi, Iwasaki Akinori
Department of General Thoracic, Breast and Paediatric Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.
Interact Cardiovasc Thorac Surg. 2012 Nov;15(5):854-8. doi: 10.1093/icvts/ivs337. Epub 2012 Aug 17.
The increased use of computed tomography has led to an increasing proportion of lung cancers that are identified when still less than 1 cm in diameter. However, there is no defined treatment strategy for such cases. The aim of this study was to investigate the surgical outcomes of small lung cancers.
A total of 143 patients were retrospectively evaluated, who had undergone a complete surgical resection for lung cancer less than 1 cm in diameter between January 1995 and December 2011.
The 143 study subjects included 62 male and 81 female patients. The mean age was 64.0 years (43-82 years). The mean tumour size was 0.8 cm (0.3-1.0 cm). Seventy-seven patients (53.8%) underwent lobectomy. Thirty-two patients (22.4%) underwent segmentectomy and 34 patients (23.8%) underwent wedge resection. The 3-, 5- and 10-year survival rates were 95.7, 92.2 and 85.7%, respectively, after resection for sub-centimetre lung cancer. There were no significant differences between sub-lobar resection and lobectomy. However, two patients (1.4%) had recurrent cancer and seven (4.9%) had lymph node metastasis.
The selection of the surgical procedure is important and a long-term follow-up is mandatory, because lung cancer of only 1 cm or less can be associated with lymph node metastasis and distant metastatic recurrence.
计算机断层扫描的使用增加，导致直径仍小于1厘米时被发现的肺癌比例不断上升。然而，对于此类病例尚无明确的治疗策略。本研究的目的是调查小肺癌的手术结果。
对1995年1月至2011年12月期间接受了直径小于1厘米的肺癌完整手术切除的143例患者进行回顾性评估。
143例研究对象包括62例男性和81例女性患者。平均年龄为64.0岁（43 - 82岁）。平均肿瘤大小为0.8厘米（0.3 - 1.0厘米）。77例患者（53.8%）接受了肺叶切除术。32例患者（22.4%）接受了肺段切除术，34例患者（23.8%）接受了楔形切除术。亚厘米级肺癌切除术后的3年、5年和10年生存率分别为95.7%、92.2%和85.7%。肺叶下切除术和肺叶切除术之间无显著差异。然而，2例患者（1.4%）出现癌症复发，7例（4.9%）出现淋巴结转移。
手术方式的选择很重要，必须进行长期随访，因为仅1厘米或更小的肺癌可能伴有淋巴结转移和远处转移复发。
