Ricci C, Rendina E A, Venuta F
Department of Thoracic Surgery, University of Rome, Italy.
Eur J Cardiothorac Surg. 1987;1(1):23-8. doi: 10.1016/s1010-7940(87)80009-x.
From January 1960 to January 1986, 77 patients with lung cancer invading the chest wall underwent operations in the Department of Thoracic Surgery at the University of Rome. Chest pain, alone or with other symptoms, was the presenting complaint in 52 patients (67%). All patients underwent thoracotomy (25 pneumonectomy, 5 bilobectomy, 23 lobectomy, 2 wedge resection, 22 no pulmonary resection), with an operative mortality of 7.8%. At thoracotomy, mediastinal lymph node dissection was performed in 36 cases; after the operation 10 patients were classified as T3 N0 M0, 11 as T3 N1 M0, 15 as T3 N2 M0; 19 patients (34.5%) were staged T3 Nx M0 because mediastinal dissection was not performed. En bloc resection of the chest wall was performed on 37 patients. The actuarial 5-year survival of 55 patients following potentially curative resection was 15%. Five-year survival was 22% for N0, 12% for N1 and 8% for N2 patients. Five-year survival for squamous cell, large cell, and adenocarcinoma was 22%, 10% and 14%, respectively. T3 N0 M0 patients with squamous cell carcinoma had a 5-year survival of 32%. Pain relief was achieved in 45% of our patients. Resection of pulmonary parenchyma and part of the thoracic wall for lung cancer yields palliation of pain in a fairly large number of patients and may result in long-term survival in selected cases.
1960年1月至1986年1月，罗马大学胸外科为77例侵犯胸壁的肺癌患者实施了手术。52例患者（67%）以胸痛单独或伴有其他症状作为就诊主诉。所有患者均接受了开胸手术（25例全肺切除术、5例双叶切除术、23例肺叶切除术、2例楔形切除术、22例未行肺切除术），手术死亡率为7.8%。开胸手术时，36例患者进行了纵隔淋巴结清扫；术后，10例患者被分类为T3 N0 M0，11例为T3 N1 M0，15例为T3 N2 M0；19例患者（34.5%）因未进行纵隔清扫而被分期为T3 Nx M0。37例患者进行了胸壁整块切除。55例接受了可能治愈性切除的患者的5年精算生存率为15%。N0患者的5年生存率为22%，N1患者为12%，N2患者为8%。鳞状细胞癌、大细胞癌和腺癌的5年生存率分别为22%、10%和14%。鳞状细胞癌的T3 N0 M0患者5年生存率为32%。45%的患者疼痛得到缓解。为肺癌切除肺实质和部分胸壁可使相当多患者的疼痛得到缓解，在某些特定病例中可能实现长期生存。
