Goya T, Miyazawa N, Kondo H, Tsuchiya R, Naruke T, Suemasu K
Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.
Cancer. 1989 Oct 1;64(7):1418-21. doi: 10.1002/1097-0142(19891001)64:7<1418::aid-cncr2820640709>3.0.co;2-n.
Pulmonary resection of metastatic lesions from colorectal cancer was performed in 62 patients, and their cumulative 5-year and 10-year survival rates were 42% and 22%, respectively. The overall median survival was 24 months. The survival curve decrease even after 5 years after pulmonary resection; four of 13 patients who survived more than 5 years subsequently died of metastatic disease and only two patients survived more than 10 years. The number and size of the pulmonary metastases were significantly correlated with postthoracotomy survival. Solitary metastases less than 3.0 cm in diameter were good indicators of favorable postthoracotomy survival. There were no significant differences in survival based on Dukes' classification or location of the primary lesion. Sex, age, disease-free interval between the primary tumor and appearance of metastasis, and extent of pulmonary resection had no influence on survival. It is impossible to say from our experience that surgical resection of pulmonary metastases increased the cure rate. Presumably a good 5-year survival rate after thoracotomy would be a reflection of a length bias caused by the biologic behavior of the metastatic pulmonary lesions.
对62例结直肠癌肺转移患者进行了肺转移瘤切除术，其5年和10年累积生存率分别为42%和22%。总体中位生存期为24个月。肺切除术后5年生存率曲线仍下降；13例存活超过5年的患者中有4例随后死于转移性疾病，只有2例存活超过10年。肺转移瘤的数量和大小与开胸术后生存率显著相关。直径小于3.0 cm的孤立转移瘤是开胸术后生存率良好的指标。基于Dukes分期或原发灶位置的生存率无显著差异。性别、年龄、原发肿瘤与转移出现之间的无病间期以及肺切除范围对生存率无影响。从我们的经验来看，无法确定肺转移瘤的手术切除提高了治愈率。推测开胸术后良好的5年生存率反映了转移性肺病变生物学行为导致的长度偏倚。
