Manac'h D, Riquet M, Dujon A, Le Pimpec-Barthes F, Debrosse D, Debesse B
Service de Chirurgie Thoracique, Hôpital Laennec, Paris.
Rev Pneumol Clin. 1994;50(4):155-9.
From April 1984 to December 1990, 66 patients 75 years of age or older underwent curative mediastinal lymph node dissection. There were 37 pneumonectomies. Post-operative mortality was 12% and was not affected by the type of dissection. Five-year survival was 16.2 +/- 6.29% (median 23 months) and was more than 45% in less elderly patients. Survival rate was highly affected by presence of metastasis in the mediastinal nodes and was zero in N2 cases. More than half of the patients died from cancer-related causes. Generally, we operate all the N2 cases which appear technically dissectable. Retrospectively, we think that N2 stage detected, and confirmed histologically in patients over 75, would be the only contra-indication for this attitude.
1984年4月至1990年12月,66例75岁及以上的患者接受了根治性纵隔淋巴结清扫术。其中37例行肺切除术。术后死亡率为12%,不受清扫类型的影响。五年生存率为16.2±6.29%(中位生存期23个月),年龄较小的患者五年生存率超过45%。生存率受纵隔淋巴结转移情况的影响很大,N2期患者的生存率为零。超过一半的患者死于癌症相关原因。一般来说,我们对所有在技术上可进行清扫的N2期病例进行手术。回顾性分析,我们认为,对于75岁以上患者,经组织学检查确诊的N2期是采取这种手术方式的唯一禁忌证。