Radical en bloc resection for lung cancer invading the spine
Radical en bloc resection for lung cancer invading the spine
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DOI：
10.1067/mtc.2002.119333
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发表时间：
2002-02-01
影响因子：
6
通讯作者：
Le Chevalier, T
中科院分区：
文献类型：
--
作者：
Grunenwald, DH;Mazel, C;Le Chevalier, T
目的：我们回顾了我们8年的经验，整块部分和全椎体切除术肺癌侵犯spinity.Methods的结果和生存报告：19例肺癌涉及脊柱进行整块切除术。11例接受诱导治疗（化疗，n = 5;放化疗，n = 4;放疗，n = 2）。3例行肺切除术，13例行肺叶切除术，3例行楔形切除术。15例行半椎体切除术，4例行全椎体切除术。切除椎体的中位数为3（范围，1-4）。14例患者的肿瘤分期为11113，1例患者为IIIA，4例患者为1113（在T3疾病的情况下进行半椎体切除术以获得游离边缘）。13例患者的手术淋巴结状态为N 0，3例患者为N1，1例患者为N2，2例患者为N3（锁骨上）。15例（79%）患者实现了完整的肉眼和显微镜下切除。在10名患者中观察到死亡，包括4名（21%）与脊柱手术相关的并发症。平均住院时间为30天。7例患者在平均随访26个月（范围，7-74个月）后存活。1年和5年预测生存率（更新）分别为59%和14%。九个局部复发observed.Conclusions：整块切除胸部肿瘤椎体切除术在技术上要求很高，术后发病率应严格解决这种积极的手术干预。然而，本系列研究中观察到的令人鼓舞的长期生存率表明，在选定的胸部肿瘤累及椎体的患者中，整块切除可能是一种有效的选择。
Objective: We reviewed our 8-year experience with en bloc partial and total vertebrectomy for lung cancer invading the spine and report outcome and survival.Methods: Nineteen patients with lung cancers involving the spine underwent en bloc resection. Eleven received induction treatment (chemotherapy, n = 5; chemoradiotherapy, n = 4; and radiation, n = 2). Pneumonectorny was performed in 3 patients, lobectomy in 13 patients, and wedge resection in 3 patients. Hemivertebrectomy was performed in 15 patients, and total vertebrectomy was performed in 4 patients. The median number of resected vertebral bodies was 3 (range, 1-4). Tumor stage was 11113 in 14 patients, IIIA in 1 patient, and 1113 in 4 patients (hemivertebrectomy is performed in the case of T3 disease to obtain free margins). Surgical nodal status was N0 in 13 patients, N1 in 3 patients, N2 in 1 patient, and N3 (supraclavicular) in 2 patients. Complete macroscopic and microscopic resection was achieved in 15 (79%) patients.Results: There was no immediate postoperative mortality. Morbidity was observed in 10 patients, including 4 (21%) complications related to the spinal surgery. The median hospital stay was 30 days. Seven patients were alive after a mean follow-up of 26 months (range, 7-74 months). The 1- and 5-year predicted survivals (updated) are 59% and 14%, respectively. Nine local recurrences were observed.Conclusions: En bloc resection of chest tumors with vertebrectomy is technically demanding, and postoperative morbidity should be critically addressed with this aggressive surgical intervention. However, an encouraging long-term survival observed in this series suggests that en bloc resection could be a valid option in selected patients with vertebral involvement of chest tumors.