Macherey Sascha, Mallmann Peter, Malter Wolfram, Doerr Fabian, Heldwein Matthias, Wahlers Thorsten, Hekmat Khosro
Medizinische Fakultät, Universität zu Köln, Köln, Germany.
Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Universität zu Köln, Köln, Germany.
Geburtshilfe Frauenheilkd. 2017 Jun;77(6):645-650. doi: 10.1055/s-0043-108252. Epub 2017 Jun 28.
Breast carcinoma with pulmonary metastasis can be treated locally or systemically. Following primary tumour resection patients with isolated, completely resectable pulmonary nodules and definite functional operability can be offered lung metastasis resection. Following metastasectomy a median survival of 32 to 96.6 months can be achieved with corresponding five-year survival rates between 30.8 and 54.4%. The procedure is associated with a mortality rate of 0 to 3%. The most important independent prognostic factor for long-term survival is complete resection of all lung lesions. The configuration and pattern of metastasis as well as disease-free interval, hormone and HER2/neu receptor status also appear to influence prognosis, but are of lesser importance. Intrapulmonary recurrence of metastases may, after careful selection on a case-by-case basis, also be treated operatively. In some cases this is associated with a favourable long-term prognosis. Pulmonary metastasectomy should be the treatment of choice for selected patients with metastatic breast carcinoma.
伴有肺转移的乳腺癌可进行局部或全身治疗。在原发性肿瘤切除后,对于孤立的、可完全切除的肺结节且具有明确功能可切除性的患者,可考虑行肺转移瘤切除术。肺转移瘤切除术后,中位生存期可达32至96.6个月,相应的五年生存率在30.8%至54.4%之间。该手术的死亡率为0%至3%。长期生存的最重要独立预后因素是所有肺部病变的完全切除。转移灶的形态和模式以及无病生存期、激素和HER2/neu受体状态似乎也会影响预后,但重要性较低。在逐例仔细筛选后,肺内转移瘤复发也可进行手术治疗。在某些情况下,这与良好的长期预后相关。对于选定的转移性乳腺癌患者,肺转移瘤切除术应作为首选治疗方法。