CAJ | 학술논문

目的探讨外科手术对同侧肺多结节型非小细胞肺癌的治疗作用.方法 1999年12月至2006年12月共对68例同侧肺多结节非小细胞肺癌患者进行完全性手术切除.男性44例,女性24例,年龄33～81岁,平均年龄为60.3岁.其中54例为同一肺叶内的多结节病灶(T4),13例为不同肺叶的多结节病灶(M1),还有1例被证实为多原发癌.本组患者采用的手术方法包括:肺叶切除、联合肺叶切除、全肺切除和肺叶切除加楔形切除,所有患者均接受了系统性纵隔淋巴结清扫.结果本组患者的中位生存时间为30个月,影响患者术后生存的主要因素是纵隔淋巴结转移状态和细支气管肺泡癌组织类型.无纵隔淋巴结转移的患者的中位生存时间为39个月,而有纵隔淋巴结转移的患者的中位生存时间为14个月(P<0.01).伴有细支气管肺泡癌成分的患者的中位生存时间为46个月,好于其他组织类型患者的20个月(P<0.01).结论外科手术可有效治疗同侧肺多结节型非小细胞肺癌,对含有细支气管肺泡癌成分和无纵隔淋巴结转移的这类患者应积极进行手术治疗.
목적 탐토외과수술대동측폐다결절형비소세포폐암적치료작용.방법 1999년12월지2006년12월공대68례동측폐다결절비소세포폐암환자진행완전성수술절제.남성44례,녀성24례,년령33～81세,평균년령위60.3세.기중54례위동일폐협내적다결절병조(T4),13례위불동폐협적다결절병조(M1),환유1례피증실위다원발암.본조환자채용적수술방법포괄:폐협절제、연합폐협절제、전폐절제화폐협절제가설형절제,소유환자균접수료계통성종격림파결청소.결과 본조환자적중위생존시간위30개월,영향환자술후생존적주요인소시종격림파결전이상태화세지기관폐포암조직류형.무종격림파결전이적환자적중위생존시간위39개월,이유종격림파결전이적환자적중위생존시간위14개월(P<0.01).반유세지기관폐포암성분적환자적중위생존시간위46개월,호우기타조직류형환자적20개월(P<0.01).결론 외과수술가유효치료동측폐다결절형비소세포폐암,대함유세지기관폐포암성분화무종격림파결전이적저류환자응적겁진행수술치료.
Objectives The staging and treatment of multi-focal non-small cell lung cancer (NSCLC) are controversial. This study evaluated the effectiveness of surgical treatment for the ipsilateral multi-focal NSCLC. Methods Sixty-eight patients with multi-focal NSCLC underwent complete resection from December 1999 to December 2006. This series included 44 males and 24 females, with a mean age of 60. 3 years old (range from 33 to 81 years old). Fifty-four patients had multiple nodules in primary lobe (T4) and 13 patients had additional nodules in non-primary lobe (M1), and a patient was proved to have synchronous primary NSCLC lesions. Surgical treatments included lobectomy in 53 cases, bilobectomy in 4 cases, pneumonectomy in 2 cases, and lobecotmy combined with wedge resection in 9 cases. Results The median overall survival time of this series was 30 months. Prognostic study demonstrated that mediastinal lymph node metastasis and bronchioloalveolar carcinoma histology had significant impact on overall survival. The median survival times were 39 months for patients with N0 and N1, and 14 months for patients with N2, respectively, and there was significant difference between the groups ( P < 0. 01 ). The difference in survival was significant between patients with bronchioloalveolar carcinoma components and other NSCLC histologic types (P <0. 01 ), and the median survival times were 46 months and 20 months, respectively. Conclusion Surgery could provide choice for multi-focal NSCLC patients (T4 and M1 ), especially for patients with bronchioloalveelar carcinoma components and without mediastinal lymph node metastasis.