Surgical Procedures in the DANTE Trial, A Randomized Study of Lung Cancer Early Detection with Spiral Computed Tomography Comparative Analysis in the Screening and Control Arm
Surgical Procedures in the DANTE Trial, A Randomized Study of Lung Cancer Early Detection with Spiral Computed Tomography Comparative Analysis in the Screening and Control Arm
复制标题
DOI：
10.1097/jto.0b013e318200f523
复制
发表时间：
2011-02-01
影响因子：
20.4
通讯作者：
Ravasi, Gianluigi
中科院分区：
文献类型：
--
作者：
Infante, Maurizio;Chiesa, Giuseppe;Ravasi, Gianluigi
背景资料：来自肺癌筛查计划与低剂量螺旋CT（LDCT）的患者人群是不同的，从一般人群访问胸外科services.Methods：回顾性分析所有手术病例的DANTE试验，随机研究肺癌筛查与LDCT。患者的特点，检查，程序，切除良性疾病，并发症，肿瘤的特点，和最终的结果进行了分析，在LDCT和在control arm.Results：在LDCT臂，77可疑病变手术治疗72例。良性病变17例（22%）。在5例肺癌病例（7%）中进行了主要的电视辅助胸腔镜手术切除，在11例（19%）中进行了肺段切除。完全切除率为93%，I期切除率为73%。两名患者在开放性肺叶切除术后局部复发，三名患者有可切除的新原发灶。在对照组中，28例患者接受了31次手术，其中5例（16%）为良性病变。没有进行重大的视频辅助胸腔镜手术切除。手术切除率88%，Ⅰ期切除率52%。五名患者局部复发，两个有第二primary.Conclusions：良性病变的手术是一个相关的问题，在筛选衍生的患者。局部控制可以通过微创技术或肺段切除术来实现;然而，发展必要的技能需要手术团队的努力。长期存活者有明显的机会发展为第二原发癌或可切除的复发，并可能受益于第二次切除。
Background: The patient population derived from lung cancer screening programs with low-dose spiral computed tomography (LDCT) is different from the general population accessing thoracic surgical services.Methods: Retrospective review of all surgical cases in the DANTE trial, a randomized study of lung cancer screening with LDCT. Patient characteristics, workup, procedures, resections for benign disease, complications, tumor features, and final outcomes have been analyzed in the LDCT and in the control arm.Results: In the LDCT arm, 77 suspicious lesions were surgically managed in 72 patients. A benign lesion was diagnosed in 17 cases (22%). Major video-assisted thoracoscopic surgery resection was carried out in five lung cancer cases (7%) and segmentectomy in 11 (19%). Complete resection was achieved in 93%, and stage I rate was 73%. Two patients had a local recurrence after open lobectomy, and three had a resectable new primary. In the control group, 28 patients underwent 31 surgical procedures, in five cases (16%) for benign lesions. No major video-assisted thoracoscopic surgery resections were carried out. Resectability rate was 88%, and stage I rate was 52%. Five patients had a local recurrence and two had a second primary.Conclusions: Surgery for benign lesions is a relevant issue in screening-derived patients. Local control may be achieved by minimally invasive techniques or segmentectomy; however, developing the necessary skills requires an effort by the surgical team. Longterm survivors have a noticeable chance of developing second primary cancers or resectable recurrences and may benefit from a second resection.