OPERATION FOR N2 SMALL-CELL LUNG-CARCINOMA
OPERATION FOR N2 SMALL-CELL LUNG-CARCINOMA
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DOI：
10.1016/0003-4975(90)90016-y
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发表时间：
1990-05-01
影响因子：
4.6
通讯作者：
EBNER, I
中科院分区：
文献类型：
--
作者：
SALZER, GM;MULLER, LC;EBNER, I
本文报告48例局限型小细胞肺癌经不同方式治疗后，均行根治性手术的25例N2淋巴结转移病例。在第一阶段（1970年至1977年）的治疗仅包括根治性切除术3例，化疗加手术6例，局部放疗加2例。自1977年以来，14例患者接受了综合治疗方案，包括根治性切除术（6例肺切除术，1例生物叶切除术，7例肺叶切除术），化疗，局部放疗和预防性颅照射。11例患者，其中N2疾病术前确诊，接受化疗作为第一步，其次是“辅助”切除。整个N2组的预计5年生存率为25%，综合治疗组为47%。后一组的7名患者在综合治疗后存活了12、19、30、48、66、73和74个月，相当于观察到的2年生存率为38%。这是在一个单一的机构治疗的N2期切除的小细胞肺癌患者的最大的报告系列;结果是如此令人鼓舞，我们不能再提倡普遍拒绝根治性肺切除术的N2期小细胞肺癌，如果它是一个多模式治疗方案的一部分。
Of 48 patients with limited small cell lung carcinoma treated by different modes, but always including radical operation, a series of 25 patients with N2 lymph node metastases is reported. In a first period (1970 to 1977) treatment consisted solely of radical resection in 3 patients; chemotherapy was added to operation in 6, and local radiotherapy was added in 2. Since 1977, 14 patients were treated according to a comprehensive therapy protocol including radical resection (six pneumonectomies, one biolobectomy, seven lobectomies), chemotherapy, local radiotherapy, and prophylactic cranial irradiation. Eleven patients, in whom N2 disease was confirmed preoperatively, received chemotherapy as the first step, followed by "adjuvant" resection. Projected 5-year survival rate is 25% for the entire N2 group and 47% for the comprehensively treated group. Seven patients of this latter group are alive 12, 19, 30, 48, 66, 73, and 74 months after comprehensive therapy, equivalent to an observed 2-year survival rate of 38%. This is the largest reported series of patients with resected small cell lung carcinoma in the N2 stage treated at a single institution; the results are so encouraging that we can no longer advocate general refusal of radical lung resection for small cell lung carcinoma in the N2 stage if it is part of a multimodal therapeutic protocol.