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[非小细胞支气管癌切除术后标准化随访研究的有效性]

[The effectiveness of standardized follow-up studies after resection of non-small cell bronchial carcinoma].

作者信息

Zieren H U, Müller J M, Petermann D, Pichlmaier H

机构信息

Klinik für Chirurgie, Universitätsklinikum Charité, Berlin.

出版信息

Langenbecks Arch Chir. 1994;379(5):299-306. doi: 10.1007/BF00186397.

Abstract

The outcomes of 190 patients in whom a non-small-cell bronchogenic carcinoma had been resected with curative intent in the Department of Surgery, University of Cologne, between 1. 1. 1977 and 31. 12. 1987 were analysed retrospectively. Sixty-seven (35%) of these patients underwent regular, 64 (34%) irregular, and 59 (31%) no standardized follow-up programmes. During follow-up procedures tumour recurrences were detected in 33 patients (25%). Thirteen (39%) of these recurrences were completely asymptomatic at the time of diagnosis. Three recurrences (9%) were resected with curative intent, but the patients died between 14 and 17 months later due to recurrent disease. Seven recurrences (21%) were treated by radiotherapy, three (9%) by chemotherapy, and 20 patients (61%) received no oncologic therapy. The survival rates after diagnosis of recurrence were not affected by the type of treatment or by the presence of clinical symptoms. There is no evidence that long-term results following resection of non-small-cell bronchogenic carcinoma can be improved by regular and standardized follow-up programmes. The observed incidence of postoperative pulmonary disorders and the patients' self-assessment underline the necessity for postoperative care after resection of bronchogenic carcinoma. Apart from clinical studies, follow-up should primarily focus on individual symptoms and should no longer include standardized investigations in asymptomatic patients except occasional X-ray checks of the thorax.

摘要

对1977年1月1日至1987年12月31日期间在科隆大学外科以根治性意图切除非小细胞支气管源性癌的190例患者的结果进行了回顾性分析。其中67例(35%)患者接受了定期随访,64例(34%)接受了不定期随访,59例(31%)未接受标准化随访计划。在随访过程中,33例患者(25%)检测到肿瘤复发。其中13例复发(39%)在诊断时完全无症状。3例复发(9%)以根治性意图切除,但患者在14至17个月后因疾病复发死亡。7例复发(21%)接受了放疗,3例(9%)接受了化疗,20例患者(61%)未接受肿瘤治疗。复发诊断后的生存率不受治疗类型或临床症状的影响。没有证据表明,通过定期和标准化的随访计划可以改善非小细胞支气管源性癌切除后的长期结果。观察到的术后肺部疾病发病率和患者的自我评估强调了支气管源性癌切除术后护理的必要性。除临床研究外,随访应主要关注个体症状,对于无症状患者,除偶尔进行胸部X光检查外,不应再包括标准化检查。

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