Practical approach to patients presenting with multiple synchronous suspect lung lesions: a reflection on the current TNM classification based on 54 cases with complete follow-up.
Practical approach to patients presenting with multiple synchronous suspect lung lesions: a reflection on the current TNM classification based on 54 cases with complete follow-up.
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针对同时出现多个可疑肺部病变的患者的实用方法：基于 54 例完整随访病例的当前 TNM 分类反思。
DOI：
10.1016/s0169-5002(01)00245-8
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发表时间：
2001
期刊：
影响因子：
5.3
通讯作者：
T. Lerut
中科院分区：
文献类型：
--
作者：
J. Vansteenkiste;Bruno De Belie;G. Deneffe;M. Demedts;P. De Leyn;D. Van raemdonck;T. Lerut
目的研究同时出现两个可疑肺部病变的患者手术治疗后的生存率，并反思最近的TNM分类，该研究将具有两个相同组织学的恶性肺部病变的患者升级为T4（两处病变均位于同侧肺叶）或M1（不同的肺叶或肺）方法在鲁汶前瞻性数据库中检索诊断为两个同步可疑肺部病变的所有连续患者，肺癌组在1990年和1994年之间的间隔。所有患者的特点和生存分析，谁进行手术切除，意图治愈两个lessones.Results48 54例患者手术切除治愈意图。其中35例证实有两个恶性病变，13例第二个病变是良性的。合并两个恶性病灶的患者5年生存率为33%（95%CI：17-49）。中位生存期为28个月。虽然在亚组中的患者数量是小的，有两个病变在相同或不同的肺叶患者之间没有明显的差异，如果一个完整的切除术可以实现. ConclusionsA积极的手术方法在精心挑选的患者提出两个可疑的肺部病变可以是有益的。虽然在相同组织学的两个恶性肺肿瘤患者中，一定程度的分期上调是适当的，但他们目前的IIIB或IV期分类可能低估了根治性切除术后长期生存的前景。
ObjectivesTo examine the survival after surgical treatment of patients presenting with two synchronous suspect lung lesions, and to reflect on the recent TNM classification, which has upgraded patients with two malignant lung lesions of the same histology into the T4 (both lesions in the same ipsilateral lobe) or M1 (different lobes or lungs) category.MethodsRetrieval of all consecutive patients with a diagnosis of two synchronous suspect lung lesions in the prospective database of the Leuven Lung Cancer Group in the interval between 1990 and 1994. Analysis of characteristics and survival of all patients, who underwent surgical resection with intention to cure for both lesions.ResultsForty-eight of 54 patients had surgical resection with curative intent. Thirty-five of these proved to have two malignant lesions, in 13 the second lesion was benign. The 5-year survival rate in the patients with two malignant lesions was 33% (95% CI: 17–49). The median survival time was 28 months. Although the number of patients in the subgroups was small, there were no obvious differences between patients with two lesions in the same or in different lobes, if a complete resection could be achieved.ConclusionsAn aggressive surgical approach in carefully selected patients presenting with two suspect pulmonary lesions can be rewarding. Although some degree of upstaging is appropriate in patients with two malignant lung tumours of the same histology, their current stage IIIB or IV classification probably underestimates their prospects for long-term survival after radical resection.