原发性支气管肺癌的外科治疗  被引量:35

Surgical Treatment of Primary Bronchogenic Carcinoma in 3568 Cases

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作  者:李世业[1] 许绍发[1] 陈肖嘉[1] 杨声[1] 林美云[1] 阎东杰[1] 

机构地区:[1]北京结核病胸部肿瘤研究所,101149

出  处:《中华胸心血管外科杂志》1995年第5期273-274,共2页Chinese Journal of Thoracic and Cardiovascular Surgery

摘  要:1957~1991年间,治疗原发性支气管肺癌3568例,手术切除率90.3%,死亡率0.89%,术后并发症发生率8%。病理分型为:鳞癌48.7%,腺癌22.9%,小细胞癌15.4%,鳞腺癌10.1%,大细胞癌1.3%。本组病人失访250例,随访率为93%。切除术后5年生存率34.6%,10年生存率为23%。病理分期、组织类型以及纵隔淋巴结转移是影响预后的主要因素。本组Ⅲ期病人1251例,占42.6%,5年生存率:Ⅲa期19%,Ⅲb期6%。重点探讨了Ⅲ期病人的手术适应证,手术有关问题及综合治疗措施。This paper summerized the surgical treatment of primary bronchogenic carcinoma in 3568 cases between 1957-1991. The resectability rate was 90. 3%, postoperative morbidity rate 8.32% and operative mortality 0. 89%. Pathological diagnoses of the resected specimens included squa-mous cell carcinoma for 48.7%, adenocarcinoma 22.9%, small cell cancer 15. 4%, large cell cancer 1. 3% and squa-mous-adenocarcinoma in 10.1%. The follow-up rate was 93%. The 5-and 10-year survival rates were 34.6% and 22.79% respectively. Analyses of the data demonstratad that the histologic type, pathological stage and metastasis of mediastinal lymph node are the important factors affecting the prognosis. According to UICC P-TNM,42. 6% of the patients in this group were in stage III. The 5 year survival rate was 19% in IIIa patients and 6% in IIIb. According to authors experience, it is recommended that in IIIa patients with nonsmall cell cardinoma, active surgical treatment should be adopted; in patients with small cell carcinoma, chemotherapy and radiotherapy should be given pre-and postoperatively, in IIIb patients with small cell carcinoma, surgical treatment is generally not indicated.

关 键 词:肺肿瘤 外科手术 手术适应证 

分 类 号:R734.205[医药卫生—肿瘤] R730.56[医药卫生—临床医学]

 

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