孤立性肺转移瘤的诊断与外科治疗(附156例报告)  

The Diagnosis and Surgical Treatment for Solitary Pulmonary Metastases:A Report of 156 Cases

作　　者：张辉[1] 陈晓峰[1] 王海兵[1] 张雷[1] 周文勇[1] 赵明川[1] 

机构地区：[1]同济大学附属上海市肺科医院胸外科,上海200433

出　　处：《中国肺癌杂志》2012年第4期223-227,共5页Chinese Journal of Lung Cancer

基　　金：国家自然科学基金(No.30872553);上海市科委基础研究重点项目(No.10JC1419200)资助~~

摘　　要：背景与目的近年来手术治疗孤立性肺转移瘤取得了满意的疗效,为提高患者的生存率,本研究对其诊断、外科治疗的适应证、手术方式及影响预后的因素进行分析讨论。方法对156例接受手术治疗的孤立性肺转移瘤患者的临床资料进行回顾性分析。结果原发肿瘤为癌者134例,肉瘤21例,不明组织类型1例。全组无围手术期死亡,随访153例,随访时间1年-10年。术后5生存率为31.2%,中位生存期为35.8个月。113例行淋巴结系统性清扫,淋巴结转移阴性和阳性患者5年生存率分别为37.3%、12.5%。行肺叶切除术患者5年生存率为38.5%。结论手术治疗孤立性肺转移瘤可取得满意的疗效,电视胸腔镜手术是有效的手术方式,有无淋巴结转移和肺叶切除方式是影响预后的重要因素。Background and objective In recent years, it has been proven that surgical treatment for solitary pul- monary metastases has achieved satisfactory results. Consequently, the study aims to investigate the diagnosis, indications for surgery, operative techniques, and prognostic factors of the surgical resection for solitary pulmonary metastases, and to improve the survival rate of patients with pulmonary metastases. Methods The medical records of 156 patients with surgical procedures at our institution were retrospectively reviewed. Results The primary tumors were verified as cancer in 134 cases, sarcoma in 21, and I contained unknown tissue. There was no perioperative mortality. A total of 153 patients returned for follow up. Follow-up time was 1 yr to 10 yr. The S-year survival rates were 31.2%. The median survival time was 35.8 months. Systematic lymph node dissection was performed in 113 patients. The 5-year survival rates were 12.5% for lymph node-positive patients and 37.3% for lymph node-negative patients. The patients who underwent lobectomies had better survival rates, with a 5-year survival rate of 38.5%. Conclusion Surgery is recommended for patients with solitary pulmonary metastasis if they fulfill the surgical indications and favorable outcomes can be achieved. VATS can be chosen for the patients. Hilar and medias- tinal lymph node involvement and the surgical approach are potentially important prognostic factors.

关 键 词：肺肿瘤 肿瘤转移 手术 诊断 预后 

分 类 号：R734.2[医药卫生—肿瘤]