[Results of surgical treatment of lung metastases from colorectal cancers].
[Results of surgical treatment of lung metastases from colorectal cancers].
复制标题
结直肠癌肺转移的手术治疗结果[J].
DOI：
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发表时间：
1995
影响因子：
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通讯作者：
P. Levasseur
中科院分区：
文献类型：
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作者：
J. Régnard;M. Nicolosi;M. Coggia;L. Spaggiari;P. Fourquier;J. Levi;P. Levasseur
客观化
这项工作的目的是确定结直肠癌肺转移手术切除后的长期结果和预后因素。
方法
对1970年至1993年间连续101例因结直肠癌肺转移行肺切除术的患者的术后临床状况和生存情况进行了研究。预后因素按手术设计进行评估。结肠切除至肺切除的平均间隔时间为44个月。单发病变59例，单侧多发病变17例，双侧多发病变25例。18例患者曾因肺外局部转移而接受手术治疗。楔形切除47例，肺叶或双叶切除40例，全肺切除11例，活检3例。
结果
无一例术后死亡，完全切除的5年生存率为21%；所有不完全切除或活检的患者均在3年内死亡。显著的预后因素是：完全切除、异时性疾病(与同步转移相比)和无淋巴结转移。结直肠病变的范围和切除转移的数目不影响预后。与单纯肺转移患者相比，切除肺外疾病患者的存活率没有显著差异。11例患者接受了再次肺切除，其中6例目前仍活着，其中3例在第二次肺切除后3年以上。
结论
我们认为，切除结直肠癌肺转移瘤是安全有效的，可切除的肺外疾病并不意味着肺切除，对于有复发的肺转移瘤患者，再次开胸手术是必要的。
OBJECTIVE
The aim of this work was to determine the long term results and the prognostic factors after surgical resection of pulmonary metastases from colorectal cancers.
METHODS
Clinical status after surgery and survival were studied in 101 consecutive patients undergoing lung resection for pulmonary metastases from colorectal carcinoma between 1970 and 1993. Prognostic factors were evaluated according to surgical design. Mean interval between colon resection and lung resection was 44 months. Fifty-nine patients had a solitary lesion, 17 had multiple unilateral lesions and 25 multiple bilateral lesions. Eighteen patients had undergone previous surgery for localized extrapulmonary metastases. A wedge resection was performed in 47 patients, lobectomy or bilobectomy in 40, pneumonectomy in 11 and biopsy in 3.
RESULTS
There was no postoperative mortality and 5-year survival in complete resection was 21%; all patients with incomplete resection or biopsy died within 3 years. Significant prognostic factors were: complete resection, metachronous disease (vs synchronous metastases) and absence of lymph node involvement. The extent of the colorectal disease and the number of resected metastases did not influence prognosis. Survival for patients with resected extrapulmonary disease was not significantly different as compared with patients with only pulmonary metastases. Eleven patients had repeat pulmonary resections, 6 of these patients are currently alive, 3 of them more than 3 years after the second pulmonary resection.
CONCLUSIONS
We conclude that resection of colorectal lung metastases is safe and effective, that resectable extrapulmonary disease does not contra-indicate pulmonary resection and that repeat thoracotomy is warranted in selected patients with recurrent lung metastases.