Niwa H, Masaoka A
Second Department of Surgery, Nagoya City University, Medical School, Japan.
Kyobu Geka. 1995 Jan;48(1):8-12.
Twenty-two patients underwent surgical therapy for local recurrence and distant metastasis of lung cancer. Twenty patients were resected the tumor and 2 patients received the operation to improve their quality of life. Seven patients were resected lung metastasis, which were 5 adenocarcinomas and 2 squamous cell carcinomas. All metastasis situated in contralateral lung of primary operation. Two lobectomies, 1 segmentectomy, and 4 partial resections were performed. The 5-year survival rate was 28.6%. Four patients were resected brain metastasis, which were 2 adeno-squamous cell carcinomas, 1 squamous cell carcinoma, and 1 large cell carcinoma. The 5-year survival rate was 25%. Three patients were resected the neck and upper mediastinal lymph node metastasis. Since those lymph nodes could not be dissected at the initial operation, different approaches, which was median sternotomy and collar incision of neck, were selected. Two patients were alive 5 months after operation. There were no long-term survivors in 5 patients with bone or soft tissue metastasis. Since the differentiation of lung metastasis from the second primary tumor is impossible, the single lung metastasis should be resected. Resection of single brain metastasis provides better prognosis.
22例患者因肺癌局部复发和远处转移接受了手术治疗。20例患者接受了肿瘤切除，2例患者接受手术以改善生活质量。7例患者切除了肺转移灶，其中5例为腺癌，2例为鳞状细胞癌。所有转移灶均位于初次手术对侧肺。实施了2例肺叶切除术、1例肺段切除术和4例部分切除术。5年生存率为28.6%。4例患者切除了脑转移灶，其中2例为腺鳞癌，1例为鳞状细胞癌，1例为大细胞癌。5年生存率为25%。3例患者切除了颈部和上纵隔淋巴结转移灶。由于这些淋巴结在初次手术时无法切除，因此选择了不同的手术入路，即胸骨正中切开术和颈部领口切口。2例患者术后存活5个月。5例骨或软组织转移患者无长期存活者。由于无法区分肺转移灶与第二原发肿瘤，因此应切除单个肺转移灶。切除单个脑转移灶可提供更好的预后。
