Roentgenographically occult lung cancer. A ten-year experience.
Roentgenographically occult lung cancer. A ten-year experience.
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DOI：
10.1016/s0022-5223(19)39149-4
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发表时间：
1983-09
期刊：
影响因子：
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通讯作者：
D. Cortese;P. Pairolero;E. Bergstralh;L. Woolner;Uhlenhopp Ma;J. Piehler;D. Sanderson;P. E. Bernatz;David E. Williams;W. Taylor;Payne Ws;R. Fontana
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文献类型：
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作者：
D. Cortese;P. Pairolero;E. Bergstralh;L. Woolner;Uhlenhopp Ma;J. Piehler;D. Sanderson;P. E. Bernatz;David E. Williams;W. Taylor;Payne Ws;R. Fontana
在过去的10年中，54例患者，所有男性，被发现有X线隐匿性肺癌。平均年龄为61岁（范围45 - 76岁）。所有患者痰细胞学检查均异常（癌41例，鳞状细胞癌13例）。所有患者均通过支气管镜检查（范围1至5次检查，平均1.5次）定位癌症。75%的肿瘤在异常痰细胞学检查的169天内定位。所有患者均行肺切除术治疗：肺叶切除术38例，全肺切除术9例，双叶切除术7例。手术死亡率为5.6%（3例患者）。切除了58例癌症，均为鳞状细胞癌（2例含有大细胞癌成分）。肿瘤TNM分类（AJC）为TIS N 0 M0 19例，T1 N 0 M0 25例，T0 N1 M0 5例，T2 N1 M0 4例，T3 N 0 M0 1例。总体5年精算生存率（仅肺癌死亡）为90%。44例TIS N 0 M0和T1 N 0 M0肿瘤患者的5年生存率为91%。目前，已有21名患者死亡，但只有10人死于肺癌。12名患者（22%）随后发生了其他肺癌。这些患者中有11人患有第二原发性鳞状肺癌，其中6人再次隐匿。我们的结论是，如果早期治疗，隐匿性肺癌患者长期生存的可能性很大。由于第二原发性肺癌的发病率很高，因此需要密切监测。
During the past 10 years, 54 patients, all men, were found to have roentgenographically occult lung cancer. The mean age was 61 years (range 45 to 76 years). All patients had abnormal findings on sputum cytologic study (carcinoma in 41 patients and squamous cell atypia in 13). The cancer was localized by bronchoscopy in all patients (range one to five examinations, mean 1.5). Seventy-five percent of the tumors were localized within 169 days of the abnormal sputum cytologic examination. Pulmonary resection for cure was performed in all patients: lobectomy in 38, pneumonectomy in nine, and bilobectomy in seven. Operative mortality was 5.6% (three patients). Fifty-eight cancers were resected, all squamous cell carcinomas (two had a component of large cell cancer). Tumor TNM classification (AJC) was TIS N0 M0 in 19 patients, T1 N0 M0 in 25, T0 N1 M0 in five, T2 N1 M0 in four, and T3 N0 M0 in one. Overall 5 year actuarial survival rate (lung cancer deaths only) was 90%. Five-year survival rate for the 44 patients with TIS N0 M0 and T1 N0 M0 neoplasms was 91%. Currently, 21 patients have died, but only 10 of lung cancer. Subsequent additional lung cancer developed in 12 patients (22%). Eleven of these patients had a second primary squamous lung cancer, six of which again were occult. We conclude that patients with occult lung cancer have a strong likelihood of long-term survival if treated early. Close surveillance is indicated because of the high incidence of a second primary lung cancer.