The Role of Surgery in the Treatment of Limited Disease Small Cell Lung Cancer Time to Reevaluate
The Role of Surgery in the Treatment of Limited Disease Small Cell Lung Cancer Time to Reevaluate
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DOI：
10.1097/jto.0b013e318189a860
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发表时间：
2008-11-01
影响因子：
20.4
通讯作者：
Goldstraw, Peter
中科院分区：
文献类型：
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作者：
Lim, Eric;Belcher, Elizabeth;Goldstraw, Peter
化疗-放疗被认为是治疗局限性疾病小细胞肺癌（SCLC）的标准程序。至于何时应该考虑手术，仍有争议。我们试图确定小细胞肺癌完全切除后的生存率和临床和病理stage.Methods预后的影响：进行了回顾性分析，谁接受手术的患者在1980年和2006年之间。患者分期根据第6版的肿瘤，淋巴结，肺癌转移分类，精算生存估计与Kaplan Meier方法和比较进行了使用考克斯regulation.Results：我们确定了59例进行竞争切除淋巴结清扫小细胞肺癌。平均年龄（SD）为62（11）岁，41（69%）例为男性。53例患者的临床分期信息可用，按IA（n = 9）、IB（n = 21）、IIA（n = 0）、IIB（n = 13）、IIIA（n = 9）、IIIB（n= 1）分期列出。中位随访时间（第1至第3四分位数）为2.8（0.79-8.65）年，1年和5年的总生存率（95%置信区间）分别为76%（65，88）和52%（40，68）。临床T分类患者的生存期无明显差异（p = 0.366）在N 0至N2淋巴结疾病范围内的患者中具有良好的总体结果（p = 0.498）。这项研究显示，接受肺切除术和淋巴结清扫的I至III期小细胞肺癌患者的生存率很高，并支持重新评估手术作为主要治疗方法的必要性，使用临床肿瘤、淋巴结、转移标准选择疾病非常有限的患者进行手术。
Chemo-radiation is considered the standard procedure for the management of limited disease small-cell lung cancer (SCLC). Controversy remains as to when surgery should be considered. We sought to determine the survival after complete resection of SCLC and the prognostic impact of clinical and pathologic stage.Methods: A retrospective review was undertaken of patients who underwent surgery between 1980 and 2006. Patients were staged according to the 6th edition of the Tumor, Node, Metastasis classification of lung cancer, actuarial survival estimated with Kaplan Meier methods and comparisons were undertaken using Cox regression.Results: We identified 59 patients who underwent compete resection with nodal dissection for SCLC. The mean age (SD) was 62 (11) years and 41 (69%) were men. Clinical staging information was available in 53, listed by stage with IA (n = 9), IB (n = 21), IIA (n = 0), IIB (n = 13), IIIA (n = 9), IIIB (n= 1). The median time to follow-up (1st to 3rd quartile) was 2.8 (0.79-8.65)years with an overall survival (95% confidence interval) at 1 and 5 years of 76% (65, 88), 52% (40, 68). There were no clear differences in the Survival of patients in clinical T categories (p = 0.366) with good overall results in patients across the spectrum of nodal disease from N0 to N2 (p = 0.498).Conclusions: This study shows excellent survival for stage I to III patients who underwent lung resection with nodal dissection for SCLC and supports the need to reevaluate surgery as primary treatment and use of clinical Tumor, Node, Metastasis criteria in the selection of patients with very limited disease for surgery.