Shah R, Sabanathan S, Mearns J, Richardson J, Goulden C
Department of Thoracic Surgery, Bradford Royal Infirmary, England.
J Cardiovasc Surg (Torino). 1997 Apr;38(2):187-9.
A retrospective analysis of 29 patients with carcinoid tumour of the lung treated between 1980 to 1995 is presented. There were 15 females and 14 males with a mean age of 57 years (range 28-72). Fourteen of the 29 carcinoids were peripheral and the remaining 15 were central. Preoperative histology was available in 17. Surgical resection was carried out in 27 patients, one patient was unfit whilst the other patient had multiple liver metastases at presentation. Surgical treatment offered were lobectomy (n = 19), pneumonectomy (n = 3), sleeve lobectomy (n = 3) and segmentectomy (n = 2). Twenty three patients were stage 1 tumours, 3 were stage II and one was stage III and 1 was stage IV. Postoperative histology confirmed typical carcinoids in 24 patients and the remaining 5 were atypical. There was one perioperative death from massive pulmonary embolism and there was no morbidity. Overall five year survival rate for patients with carcinoid was 96.4%. Five year survival for typical carcinoid and that of atypical carcinoid was 100% and 77.8% respectively. Typical carcinoids carry an excellent prognosis and should be offered conservative lung resection, whilst atypical carcinoids which behave aggressively should be treated by radical lung resections.
本文对1980年至1995年间接受治疗的29例肺类癌患者进行了回顾性分析。其中女性15例,男性14例,平均年龄57岁(范围28 - 72岁)。29例类癌中14例为周围型,其余15例为中央型。17例患者有术前组织学检查结果。27例患者接受了手术切除,1例患者因身体状况不佳未手术,另1例患者初诊时已有多发肝转移。手术治疗方式包括肺叶切除术(n = 19)、全肺切除术(n = 3)、袖状肺叶切除术(n = 3)和肺段切除术(n = 2)。23例患者为Ⅰ期肿瘤,3例为Ⅱ期,1例为Ⅲ期,1例为Ⅳ期。术后组织学检查证实24例为典型类癌,其余5例为非典型类癌。围手术期有1例因大面积肺栓塞死亡,无其他并发症。类癌患者的总体五年生存率为96.4%。典型类癌和非典型类癌的五年生存率分别为100%和77.8%。典型类癌预后良好,应采用保守性肺切除术,而具有侵袭性的非典型类癌则应采用根治性肺切除术。