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[复发性和第二原发性肺癌的再次手术]

[Reoperation for recurrent and second primary lung cancer].

作者信息

Murakami S, Shimizu J, Oda M, Hayashi Y, Yazaki U, Go T, Matsumoto I, Hara T, Tawaraya K, Watanabe Y

机构信息

Department of Surgery, Kanazawa University, School of Medicine, Japan.

出版信息

Kyobu Geka. 1995 Jan;48(1):38-42.

PMID:7869632
Abstract

Thirty patients have undergone multiple resections for non-small cell lung cancer from 1973 to July 1994, constituting 2.6% of 1,153 who had undergone pulmonary resection for such tumor. In the 22 patients for recurrent cancer, 15 resections of the ipsilateral lung and 9 of the contralateral lung were performed with no operative death. The survival rate following second resection in 22 patients was 33.8% at 3 years and 13.5% at 5 years. Survival rate was poor in patients with DNA aneuploid primary tumor and there was not a patients of 5 years survival. Three out of the 5 patients which had a diploid pattern in the primary tumor, showed an aneuploid pattern in the recurrent tumor. Long survival patients were founded only in the patients which had a diploid primary tumor. In the 8 patients for second primary lung cancer, 4 resections of the ipsilateral lung and 4 of the contralateral lung were performed, including two bronchoplastic surgery for early hilar squamous cell carcinoma. The survival rate following second resection in 8 patients was 64.2% at 5 years with good result. We concluded that an aggressive surgical approach is safe and warranted in patients with second primary lung cancer.

摘要

1973年至1994年7月,30例患者因非小细胞肺癌接受了多次手术切除,占1153例因该肿瘤接受肺切除术患者的2.6%。在22例复发性癌症患者中,对同侧肺进行了15次切除,对侧肺进行了9次切除,无手术死亡。22例患者二次切除后的3年生存率为33.8%,5年生存率为13.5%。DNA非整倍体原发性肿瘤患者的生存率较差,无5年生存患者。原发性肿瘤为二倍体模式的5例患者中,有3例复发性肿瘤显示为非整倍体模式。长期生存患者仅见于原发性肿瘤为二倍体的患者。在8例第二原发性肺癌患者中,对同侧肺进行了4次切除,对侧肺进行了4次切除,其中包括2例早期肺门鳞状细胞癌的支气管成形手术。8例患者二次切除后的5年生存率为64.2%,效果良好。我们得出结论,积极的手术方法对第二原发性肺癌患者是安全且必要的。

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