2023年度肺癌外科治疗领域重要进展  

Important progress in surgical treatment of lung cancer in 2023

作　　者：钱斌 陈海泉[1,3] QIAN Bin;CHEN Haiquan(Department of Thoracic Surgery,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;Department of Thoracic Surgery,Jiangdu People’s Hospital of Yangzhou City,Yangzhou 225000,Jiangsu Province,China;Institute of Thoracic Oncology,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属肿瘤医院胸外科,复旦大学上海医学院肿瘤学系,上海200032 [2]扬州市江都人民医院胸外科,江苏扬州225000 [3]复旦大学胸部肿瘤研究所,上海200032

出　　处：《中国癌症杂志》2024年第4期335-339,共5页China Oncology

摘　　要：肺癌是中国发病率和死亡率最高的恶性肿瘤,外科手术是肺癌治疗的重要手段。2023年,肺癌外科治疗领域取得了多项重要进展。首先是CALGB140503研究结果公布,该研究表明,对于周围型≤2 cm小结节肺癌,亚肺叶切除与肺叶切除术在生存率上差异无统计学意义,为确立亚肺叶切除术在早期肺癌治疗中的地位奠定了基础。其次,JCOG1211研究发现肺段切除术可以用于治疗2~3 cm磨玻璃结节为主的肺腺癌,但是该研究存在过度治疗现象,通过术中快速冷冻切片病理学检查可能降低过度治疗的风险。ECTOP-1003研究提出了基于肿瘤部位和术中快速冷冻切片病理学检查的选择性淋巴结清扫策略,准确率达100%,为淋巴结清扫提供了更加精准的方案。此外,对于肺腺癌治愈窗口期的探索成果也引人瞩目,即在早期肺癌治疗中,需要把握手术治愈的时间窗,避免过度治疗。最后,ECTOP-1008研究结果显示,高分辨率胸部CT有助于判断肺癌的病理浸润程度,有助于治愈窗口期的精准判断。本文对2023年度肺癌外科治疗领域的重要研究进展予以回顾,以期为肺癌外科治疗的临床实践及未来的临床研究提供思路。Lung cancer is the malignant tumor with the highest incidence and mortality rate in China,and surgical resection is a crucial approach for its treatment.In 2023,significant advancements were made in the field of lung cancer surgery.Firstly,CALGB140503 showed that for peripheral≤2 cm nodular lung cancer,sublobar resection demonstrated no significant difference in survival rates compared to lobectomy,establishing the foundation for its role in early lung cancer treatment.Secondly,JCOG1211 found that segmentectomy could be used to treat 2-3 cm ground-glass opacity-predominant adenocarcinoma,however,patient in this study may undergo overtreatment,which could potentially be mitigated through intraoperative rapid frozen section pathological examination.Furthermore,the ECTOP-1003 study proposed a selective lymph node dissection strategy based on tumor location and intraoperative rapid frozen section pathological examination,achieving a 100%accuracy rate and providing a more precise approach to lymph node dissection.Additionally,the exploration of the cure time window for lung adenocarcinoma was remarkable,emphasizing the importance of timing in surgical intervention to avoid overtreatment in early lung cancer treatment.Finally,the ECTOP-1008 study demonstrated that high-resolution chest computed tomography(CT)scans assisted in determining the pathological invasion degree of lung cancer,aiding in the precise judgment of curative time window.This review summarized the important research progress in the field of lung cancer surgery in 2023,aiming to provide insights for clinical practice and future trials in lung cancer surgery.

关 键 词：肺癌 研究进展 亚肺叶切除 治愈窗口期 

分 类 号：R734.2[医药卫生—肿瘤]