Osterlind K, Hansen M, Hansen H H, Dombernowsky P, Rørth M
Thorax. 1985 Apr;40(4):272-7. doi: 10.1136/thx.40.4.272.
A therapeutic policy of surgery in the treatment of small cell carcinoma of the lung was evaluated in a retrospective series of 874 consecutive patients. All patients were included in one of six clinical trials of intensive combination chemotherapy and radiotherapy, carried out during 1973-81. General criteria of resectability, including normal appearances at mediastinoscopy, were fulfilled in 33 electively operated patients and in 46 non-operated patients. An elective operation was defined as a thoracotomy performed with the intention of pulmonary resection in a patient known to have small cell carcinoma. Pneumonectomy or lobectomy was performed in 73% of the electively operated patients. Residual macroscopic or microscopic tumour tissue was left after half of these resections. Both operated patients and non-operated patients with operable tumours survived significantly longer than 696 patients deemed to have been inoperable. There was no significant difference, however, in the duration of survival between the two subsets of operable patients. According to this analysis, a treatment policy of surgery for resectable small cell carcinoma does not lead to better overall results than treatment with chemotherapy and radiotherapy alone.
对874例连续的小细胞肺癌患者进行回顾性研究，评估了手术治疗小细胞肺癌的治疗策略。所有患者均纳入了1973年至1981年间进行的6项强化联合化疗和放疗临床试验之一。33例接受选择性手术的患者和46例未手术的患者符合可切除性的一般标准，包括纵隔镜检查外观正常。选择性手术定义为对已知患有小细胞肺癌的患者进行旨在肺切除的开胸手术。73%的选择性手术患者接受了肺切除术或肺叶切除术。这些切除术中半数术后留有肉眼或显微镜下可见的肿瘤残留组织。手术患者和有可手术肿瘤的未手术患者的生存期均显著长于696例被认为不可手术的患者。然而，两组可手术患者的生存期无显著差异。根据该分析，对于可切除的小细胞肺癌，手术治疗策略并不比单纯化疗和放疗能带来更好的总体疗效。
