Yoshino I, Nakanishi R, Osaki T, Hasuda S, Taga S, Takenoyama M, Yoshimatsu T, Yasumoto K
Department of Surgery II, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Ann Thorac Surg. 1997 Sep;64(3):809-13. doi: 10.1016/s0003-4975(97)00281-6.
Non-small cell lung cancer with intrapulmonary metastasis (PM) was recently reclassified according to the revision of the TNM classification. To determine whether the new staging system is appropriate, we analyzed the postoperative prognosis of patients with synchronously detected and resected PM lesions.
Of 509 patients with non-small cell lung cancer who underwent surgical resection, 42 patients were revealed to have synchronous and ipsilateral PM. Their survival was compared with that of matched stage groups (without PM) by Kaplan-Meier test and log rank test.
Two patients who were classified as stage I survived 40 and 30 months after operation, respectively. One patient was determined to be stage II, and survived 100 months postoperatively. Thirty-eight patients were classified as stage IIIA/IIIB (19 each) (90.5% of all cases with PM). There was no significant difference between 3- and 5-year survival rates of the PM stage IIIA group (34.2% and 34.2%) and those of the other IIIA (144 patients; 37.9% and 31.6%). Survival rates of such stage IIIA subgroups as PM, T3 and N2, were comparable. No significant differences were observed between the 3- and 5-year survival rates of the PM stage IIIB (16.6/16.6%) and those of the other stage IIIB (45 cases; 11.7% and 0.0%). The survival rates of such stage IIIB subgroups as PM, T4 and N3 were also similar.
The new staging system for patients with synchronous resectable PM appears to be reasonable regarding survival. Most cases of PM are categorized as locally advanced disease; however, stage IIIA/IIIB cases have become a more heterogeneous population.
非小细胞肺癌伴肺内转移（PM）最近根据TNM分类的修订进行了重新分类。为了确定新的分期系统是否合适，我们分析了同步检测并切除的PM病变患者的术后预后。
在509例行手术切除的非小细胞肺癌患者中，42例被发现有同步同侧PM。通过Kaplan-Meier检验和对数秩检验将他们的生存率与匹配的分期组（无PM）进行比较。
两名被分类为I期的患者术后分别存活了40个月和30个月。一名患者被确定为II期，术后存活了100个月。38例患者被分类为IIIA/IIIB期（各19例）（占所有PM病例的90.5%）。PM IIIA期组的3年和5年生存率（34.2%和34.2%）与其他IIIA期组（144例；37.9%和31.6%）之间无显著差异。PM、T3和N2等IIIA亚组的生存率相当。PM IIIB期组的3年和5年生存率（16.6%/16.6%）与其他IIIB期组（45例；11.7%和0.0%）之间未观察到显著差异。PM、T4和N3等IIIB亚组的生存率也相似。
对于同步可切除PM患者的新分期系统在生存率方面似乎是合理的。大多数PM病例被归类为局部晚期疾病；然而，IIIA/IIIB期病例已成为一个更加异质的群体。
