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胰腺癌后原发性肺癌手术切除的结果

Outcomes of Surgical Resection of Primary Lung Cancer After Pancreatic Cancer.

作者信息

Miyashita Yudai, Ose Naoko, Okami Jiro, Takami Koji, Sakamaki Yasushi, Ikeda Naoki, Kodama Ken, Tokunaga Toshiteru, Shintani Yasushi

机构信息

Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, JPN.

Department of Thoracic Surgery, Osaka International Cancer Institute, Osaka, JPN.

出版信息

Cureus. 2024 Nov 14;16(11):e73689. doi: 10.7759/cureus.73689. eCollection 2024 Nov.

Abstract

OBJECTIVE

This study aimed to elucidate the therapeutic significance of lung resection for primary lung cancer after pancreatic cancer surgery in contemporary cases.

METHODS

This retrospective cohort study included patients who had lung nodules and performed pulmonary resection after pancreatic cancer surgery at seven hospitals affiliated with the Thoracic Surgery Study Group of Osaka University between January 2009 and December 2021. Patients in which surgery was performed for biopsy purposes, those with a history of other cancers with potential for lung metastasis, patients who did not give their consent for enrollment, and patients determined to be ineligible by the attending physician were excluded from the study.

RESULTS

A demographic analysis revealed that 17 patients were eligible for inclusion. Pathological diagnoses were established by institutional pathologists and occasionally aided by immunostaining and genetic testing. A survival analysis revealed a 3-year survival rate of 61.9% and a 5-year survival rate of 54.2% after lung resection. Subgroup analyses highlighted the impact of the interval between pancreatic cancer surgery and lung nodule detection, tumor diameter, and procedure on survival outcomes.

CONCLUSIONS

This study underscores the therapeutic implications of lung resection for primary lung cancer following surgery for pancreatic cancer. Despite the challenges in preoperative diagnosis and treatment decisions, surgical intervention demonstrates promise, especially in select cases. Further research is needed to determine the best therapeutic strategies for this group.

摘要

目的

本研究旨在阐明当代病例中胰腺癌手术后原发性肺癌肺切除的治疗意义。

方法

这项回顾性队列研究纳入了2009年1月至2021年12月期间在大阪大学胸外科研究组下属的七家医院接受胰腺癌手术后出现肺结节并接受肺切除的患者。因活检目的而进行手术的患者、有其他可能发生肺转移癌症病史的患者、未同意入组的患者以及经主治医生判定不符合条件的患者被排除在研究之外。

结果

人口统计学分析显示,17例患者符合纳入标准。病理诊断由机构病理学家确定,偶尔借助免疫染色和基因检测。生存分析显示,肺切除术后3年生存率为61.9%,5年生存率为54.2%。亚组分析突出了胰腺癌手术与肺结节检测之间的时间间隔、肿瘤直径和手术方式对生存结果的影响。

结论

本研究强调了胰腺癌手术后原发性肺癌肺切除的治疗意义。尽管术前诊断和治疗决策存在挑战,但手术干预显示出前景,尤其是在特定病例中。需要进一步研究以确定该组患者的最佳治疗策略。

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