RESULTS OF RESECTION IN NON-OAT CELL-CARCINOMA OF THE LUNG WITH MEDIASTINAL LYMPH-NODE METASTASES
RESULTS OF RESECTION IN NON-OAT CELL-CARCINOMA OF THE LUNG WITH MEDIASTINAL LYMPH-NODE METASTASES
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DOI：
10.1097/00000658-198309000-00015
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发表时间：
1983-01-01
影响因子：
9
通讯作者：
BEATTIE, EJ
中科院分区：
文献类型：
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作者：
MARTINI, N;FLEHINGER, BJ;BEATTIE, EJ
本文报告1974 ~ 1981年收治非燕麦细胞肺癌1598例。所有患者均根据AJC分期系统进行分期。其中，706例患者有纵隔淋巴结转移的证据（N2）。有151名患者（21%）完成了原发肿瘤和所有可触及纵隔淋巴结的完全、潜在治愈性切除。肿瘤的组织学类型为腺癌94例，表皮样癌46例，大细胞癌11例。肺切除范围包括119例肺叶切除术，26例全肺切除术，6例楔形切除术或肺段切除术。几乎所有的病人也接受了放射治疗的纵隔。原发肿瘤和纵隔的临床分期是基于胸部的放射学表现和支气管镜检查。在治疗前，151例患者中有104例（69%）被认为患有I期（90例患者）或II期（14例患者）疾病，47例患者患有III期疾病，其中只有33例有纵隔淋巴结受累的证据。排除不相关原因的死亡，1年总生存率为74%，3年为43%，5年为29%。尽管存在N2淋巴结（3年时50%），但通过切除治疗的临床I期或II期疾病患者的生存率是有利的。明显临床N2疾病的生存率很低（3年时为8%）。腺癌和表皮样癌患者的生存率无差异。然而，与下纵隔无淋巴结转移的患者相比，下纵隔有N2淋巴结转移的患者生存率更低。
From 1974 to 1981, 1598 patients with non-oat cell carcinoma of the lung were seen and treated. All were staged according to the AJC staging system. Of these, 706 patients had evidence of mediastinal lymph node metastases (N2). There were 151 patients (21%) who had complete, potentially curative resection of their primary tumor and all accessible mediastinal lymph nodes. The histologic type of tumor was adenocarcinoma in 94 patients, epidermoid carcinoma in 46 patients, and large-cell carcinoma in 11 patients. The extent of pulmonary resection consisted of a lobectomy in 119 patients, pneumonectomy in 26 patients, and wedge resection or segmentectomy in six patients. Almost all patients also received radiation therapy to the mediastinum. Clinical staging of the primary tumor and the mediastinum was based on the radiographic presentation of the chest and on bronchoscopy. Before treatment, 104 of 151 patients (69%) were believed to have had stage I (90 patients) or II (14 patients) disease, and 47 patients had stage III disease, of whom only 33 had evidence of mediastinal lymph node involvement. Excluding deaths from unrelated causes, the overall survival rate was 74% at 1 year, 43% at 3 years and 29% at 5 years. Survival in patients with clinical stage I or II disease treated by resection was favorable despite the presence of N2 nodes (50% at 3 years). Survival in obvious clinical N2 disease was poor (8% at 3 years). There was no difference in survival between patients with adenocarcinoma and those with epidermoid carcinoma. However, survival was poorer in patients with N2 nodes in the inferior mediastinum compared to those without lymph node involvement at that level.