Higuchi Mitsunori, Takagi Hironori, Ozaki Yuki, Inoue Takuya, Watanabe Yuzuru, Yamaura Takumi, Fukuhara Mitsuro, Muto Satoshi, Okabe Naoyuki, Matsumura Yuki, Hasegawa Takeo, Osugi Jun, Hoshino Mika, Shio Yutaka, Suzuki Hiroyuki
Department of Thoracic Surgery, Aizu Medical Center, Fukushima Medical University.
Department of Chest Surgery, Fukushima Medical University School of Medicine.
Fukushima J Med Sci. 2018 Apr 17;64(1):30-37. doi: 10.5387/fms.2017-10. Epub 2018 Feb 20.
According to previous reports, lobectomy with bronchoplasty or angioplasty is a more feasible surgery than pneumonectomy for central-type non-small cell lung cancer. However, few studies have compared both the short- and long-term outcomes between pneumonectomy and pulmonary function-preserving surgery.
From January 2004 to December 2015, 18 patients underwent pneumonectomy (Group PN) and 12 patients underwent pulmonary function-preserving surgery (group PS) at Fukushima Medical University Hospital. Clinicopathological factors were statistically compared between the two groups.
The operation times in Group PN and Group PS were 285.9±27.9 and 271.3±99.2 min, respectively (p=0.613), while the amounts of intraoperative bleeding were 324.8±248.9 and 164.5±116.6 g, respectively (p=0.020). The duration of chest drainage and hospitalization after surgery in both groups were not significantly different but there was a tendency toward shorter periods of these durations in Group PS. The 5-year disease-free survival (DFS) rate in Group PN and PS was 51.4% and 74.1%, respectively, without a significant difference (p=0.298). The 5-year overall survival (OS) rate in Group PN and PS was 52.5% and 56.6%, respectively, also without a significant difference (p=0.748). The 5-year OS rate was inferior to the 5-year DFS rate in Group PS, and the 5-year OS rate was not better than the 5-year DFS rate in Group PN.
The short-term results were better in Group PS than PN. However, the long-term results in both groups were similar. Other causes of death influenced OS in both groups; this result might have been affected by the surgical procedures.
根据既往报道,对于中央型非小细胞肺癌,肺叶切除联合支气管成形术或血管成形术比全肺切除术是更可行的手术方式。然而,很少有研究比较全肺切除术与保留肺功能手术的短期和长期结局。
2004年1月至2015年12月,福岛医科大学医院18例患者接受了全肺切除术(PN组),12例患者接受了保留肺功能手术(PS组)。对两组的临床病理因素进行统计学比较。
PN组和PS组的手术时间分别为285.9±27.9分钟和271.3±99.2分钟(p=0.613),而术中出血量分别为324.8±248.9克和164.5±116.6克(p=0.020)。两组术后胸腔引流时间和住院时间无显著差异,但PS组有这些时间更短的趋势。PN组和PS组的5年无病生存率(DFS)分别为51.4%和74.1%,无显著差异(p=0.298)。PN组和PS组的5年总生存率(OS)分别为52.5%和56.6%,也无显著差异(p=0.748)。PS组的5年OS率低于5年DFS率,PN组的5年OS率不优于5年DFS率。
PS组的短期结果优于PN组。然而,两组的长期结果相似。其他死亡原因影响了两组的OS;这一结果可能受到手术方式的影响。