70岁及以上非小细胞肺癌患者的外科治疗
Surgical treatment of non-small cell lung cancer in patients 70 years of age or older.
作者信息
Ciriaco P, Zannini P, Carretta A, Melloni G, Chiesa G, Canneto B, Puglisi A
机构信息
Department of Cardio-Thoracic Surgery, Scientific Institute Hospital San Raffaele, Milan, Italy.
出版信息
Int Surg. 1998 Jan-Mar;83(1):4-7.
BACKGROUND
Indications to surgical treatment of lung cancer in the elderly are still being discussed. The aim of this study was to evaluate postoperative complications and survival after surgery for non-small cell lung cancer (NSCLC) in patients 70 years of age or older.
METHODS
During a 4 year and 6 month period, 76 patients (67 men and 9 women) entered the study.
RESULTS
Postoperative complications occurred in 15 cases (19.7%) and the 30-day operative mortality was 1.3%. The overall 54 month actuarial survival was 53%. Mortality at 12 months wasn't related to stage of disease, histology or lobectomy versus wedge resection but was higher in those patients who had had postoperative cardiopulmonary complications. Results of preoperative spirometry, blood gas and cardiac status were predictive of mortality at twelve months (p < 0.05).
CONCLUSIONS
Surgery for NSCLC in the elderly should not be denied on the basis of age alone. Postoperative outcome is mainly related to concomitant cardiopulmonary disease.
背景
老年肺癌患者的手术治疗指征仍在讨论中。本研究的目的是评估70岁及以上非小细胞肺癌（NSCLC）患者手术后的并发症及生存率。
方法
在4年6个月的时间里，76例患者（67例男性和9例女性）进入研究。
结果
15例（19.7%）出现术后并发症，30天手术死亡率为1.3%。54个月的总精算生存率为53%。12个月时的死亡率与疾病分期、组织学类型或肺叶切除术与楔形切除术无关，但术后有心肺并发症的患者死亡率更高。术前肺活量测定、血气分析和心脏状况的结果可预测12个月时的死亡率（p<0.05）。
结论
老年NSCLC患者不应仅因年龄而被拒绝手术。术后结果主要与伴发的心肺疾病有关。
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