Magilligan D J, Duvernoy C, Malik G, Lewis J W, Knighton R, Ausman J I
Ann Thorac Surg. 1986 Oct;42(4):360-4. doi: 10.1016/s0003-4975(10)60536-x.
From 1960 to 1985, 41 patients underwent resection of a lung cancer and one or more brain metastases. There were 24 men and 17 women ranging in age from 40 to 71 years (average, 56 years). Cell type was adenocarcinoma in 19 patients, squamous in 16, small cell in 4, and large cell in 2. Wedge resection was performed in 4 patients, lobectomy in 20, pneumonectomy in 14, and bilobectomy in 3. Brain irradiation was used for 25 patients (61%). To date, the longest survival is 18.3 years after craniotomy; mean survival is 2.3 years +/- 3.8 (+/- standard deviation). Survival was 55 +/- 7.9% (+/- standard error) at 1 year, 31 +/- 7.4% at 2 years, 21 +/- 6.5% at 5 years, and 15 +/- 6.0% at 10 years. Using multivariate analysis, we evaluated possible significant predictors of improved survival. Only wedge resection was a significant predictor (p less than .01), which suggests better results with a small peripheral lung tumor. Results of our 25 years' experience using an aggressive approach to lung cancer with solitary cerebral metastasis indicate significantly improved patient survival that justifies its widespread use.
1960年至1985年期间，41例患者接受了肺癌切除术及一处或多处脑转移瘤切除术。其中男性24例，女性17例，年龄在40至71岁之间（平均56岁）。细胞类型为腺癌19例，鳞癌16例，小细胞癌4例，大细胞癌2例。4例行楔形切除术，20例行肺叶切除术，14例行全肺切除术，3例行双叶切除术。25例患者（61%）接受了脑部放疗。迄今为止，开颅术后最长存活时间为18.3年；平均存活时间为2.3年±3.8年（±标准差）。1年生存率为55±7.9%（±标准误），2年生存率为31±7.4%，5年生存率为21±6.5%，10年生存率为15±6.0%。通过多因素分析，我们评估了可能改善生存的显著预测因素。只有楔形切除术是一个显著的预测因素（p<0.01），这表明小的周围型肺肿瘤预后较好。我们25年来采用积极方法治疗伴有孤立性脑转移的肺癌的经验表明，患者生存率显著提高，证明其可广泛应用。
