肺癌小细胞癌的手术切除：一项回顾性研究。

Surgical resection for small cell carcinoma of the lung: a retrospective study.

作者信息

Smit E F, Groen H J, Timens W, de Boer W J, Postmus P E

机构信息

Department of Pulmonary Diseases, University Hospital, Groningen, The Netherlands.

出版信息

Thorax. 1994 Jan;49(1):20-2. doi: 10.1136/thx.49.1.20.

DOI:10.1136/thx.49.1.20

PMID:8153935

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC474078/

Abstract

BACKGROUND

A retrospective review was undertaken of the survival of 21 patients with histologically proven small cell carcinoma of the lung resected between 1977 and 1991.

METHODS

Twenty one patients (20 men) of median age 60 (range 44-73) years underwent surgical resection. Patients were subjected to standard clinical staging procedures. Preoperative diagnosis was small cell carcinoma of the lung in 13, non-small cell lung cancer in one, and uncertain in seven patients. Clinical staging was stage I disease in 11 and stage II in 10 patients.

RESULTS

Resection included pneumonectomy in 12 cases, lobectomy in eight, and one wedge resection. Resection was complete in 16 patients. Postoperative histopathological examination confirmed small cell carcinoma of the lung in 19 specimens and mixed small cell and non-small cell carcinoma of the lung in two. Pathological staging was stage I in 11, stage II in three, and stage III in seven patients. The final pathological diagnosis of the resected specimens (n = 18) was atypical carcinoid in one, pure small cell carcinoma of the lung in 15, and mixed small cell and non-small cell carcinoma of the lung in two patients. Fourteen patients also received chemotherapy and 10 received prophylactic cranial irradiation postoperatively. Excluding the patient with a final diagnosis of atypical carcinoid, the median survival (n = 20) was 29 months (range two to 133+). Median survival for patients with pathological stage I and II disease (n = 13) was 40 months (range nine to 133+) and for patients with pathological stage III disease (n = 7) 20 months (range two to 116+). The median disease free survival was 23 months. Eleven patients relapsed between two and 101 months. There was no advantage for those patients who received postoperative chemotherapy.

CONCLUSION

Curative resection offers the best chance for long term survival in patients with small cell carcinoma of the lung with very limited stage disease.

摘要

背景

对1977年至1991年间接受手术切除且经组织学证实为肺小细胞癌的21例患者的生存情况进行了回顾性研究。

方法

21例患者（20例男性），中位年龄60岁（范围44 - 73岁）接受了手术切除。患者接受了标准的临床分期检查。术前诊断为肺小细胞癌的有13例，非小细胞肺癌1例，7例诊断不明确。临床分期为Ⅰ期疾病的有11例，Ⅱ期疾病的有10例。

结果

切除方式包括全肺切除术12例，肺叶切除术8例，楔形切除术1例。16例患者切除彻底。术后组织病理学检查在19份标本中证实为肺小细胞癌，2份为肺小细胞与非小细胞混合癌。病理分期为Ⅰ期的有11例，Ⅱ期的有3例，Ⅲ期的有7例。切除标本（n = 18）的最终病理诊断为1例非典型类癌，15例为纯肺小细胞癌，2例为肺小细胞与非小细胞混合癌。14例患者术后还接受了化疗，10例接受了预防性颅脑照射。排除最终诊断为非典型类癌的患者，中位生存期（n = 20）为29个月（范围2至133 +）。病理Ⅰ期和Ⅱ期疾病患者（n = 13）的中位生存期为40个月（范围9至133 +），病理Ⅲ期疾病患者（n = 7）的中位生存期为20个月（范围2至116 +）。无病生存期的中位数为23个月。11例患者在2至101个月之间复发。接受术后化疗的患者并无优势。