Ratto G B, Fabiano F, Rovida S, Baracco F, De Palma M
Cattedra di Semeiotica Chirurgica 1 alpha, Università di Genova.
Ital J Surg Sci. 1988;18(4):377-83.
In order to evaluate the effects of incomplete resection or exploratory thoracotomy on survival, 75 patients with Stage III non small-cell lung cancer (NSCLC) were studied. Twenty-five subjects underwent incomplete resection, 25 had exploratory thoracotomy and 25 patients who were denied surgery served as controls. Standard radio-therapy and chemotherapy regimens were given to most patients. The 2-year survival rates were 14%, 7% and 9% following incomplete resection, exploratory thoracotomy or conservative treatment, respectively. The survival curve was significantly worse in the exploratory thoracotomy group than in the control group (p less than 0.05). Major complications occurred in 2 patients after incomplete resection (bronchopleural fistula; chylothorax) and in 3 patients following surgical exploration (atelectasis). Two post-operative deaths were recorded in the exploratory thoracotomy group. In conclusion, the survival rate at 2 years in patients with Stage III NSCLC is not modified by incomplete or exploratory surgery. Moreover, exploration seems to worsen the outlook of patients during the first 2 years from diagnosis.
为了评估不完全切除或开胸探查术对生存的影响,我们研究了75例Ⅲ期非小细胞肺癌(NSCLC)患者。25例患者接受了不完全切除,25例进行了开胸探查术,另有25例被拒绝手术的患者作为对照。大多数患者接受了标准的放疗和化疗方案。不完全切除、开胸探查术或保守治疗后2年生存率分别为14%、7%和9%。开胸探查术组的生存曲线明显比对照组差(p<0.05)。不完全切除术后2例患者出现主要并发症(支气管胸膜瘘;乳糜胸),手术探查后3例患者出现并发症(肺不张)。开胸探查术组记录到2例术后死亡。总之,Ⅲ期NSCLC患者的2年生存率不会因不完全或探查性手术而改变。此外,探查似乎会使患者从诊断开始的头2年预后变差。