Tsuchiya R
Department of Surgery National Cancer Center Hospital, Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 1997 Jan;98(1):26-30.
Only one third of the patients with lung cancer can be identified as operative candidates. For the other two thirds operation was not indicated, because they have advanced lung cancer with distant metastases or locally advanced lung cancer invading neighboring organs. The results of surgery of lung cancer depend on TNM staging. Resection of stage IIIA, IIIB and IV were not indicated because these gave poor 5-year survival rates. However, a few 5-years survivors without any evidence of recurrence of lung cancer have been reported recently. Chest wall resection and tracheal carinal resection became standard operations because they given a 5-year survival rates of 30% and 34% respectively. Left atrium resection also becomes a standard operation with 22% of 5-year survival rate. Resection of superior vena cava is applied for locally advanced cases with or without invasion to the tracheal carina. Resection of vertebra and main pulmonary artery are being tried with careful and exact evaluation of the extent of primary tumor and invading organs using information provided by new diagnostic equipment.
只有三分之一的肺癌患者可被确定为手术候选者。另外三分之二的患者不适合手术，因为他们患有伴有远处转移的晚期肺癌或侵犯邻近器官的局部晚期肺癌。肺癌手术的结果取决于TNM分期。IIIA期、IIIB期和IV期患者不适合进行切除手术，因为这些患者的5年生存率很低。然而，最近有报道称，有少数肺癌患者存活了5年且没有任何复发迹象。胸壁切除术和气管隆突切除术已成为标准手术，因为它们的5年生存率分别为30%和34%。左心房切除术也成为一种标准手术，5年生存率为22%。上腔静脉切除术适用于有或无气管隆突侵犯的局部晚期病例。目前正在尝试进行椎体和主肺动脉切除术，同时利用新诊断设备提供的信息，对原发性肿瘤和受侵器官的范围进行仔细、准确的评估。
