Surgical treatment of 125 patients with non-small cell lung cancer and chest wall involvement

被引:34
|
作者
Pitz, CCM
delaRiviere, AB
Elbers, HRJ
Westermann, CJJ
vandenBosch, JMM
机构
[1] ST ANTONIUS HOSP,DEPT PULMONOL,NL-3430 EM NIEUWEGEIN,NETHERLANDS
[2] ST ANTONIUS HOSP,DEPT THORAC SURG,NL-3430 EM NIEUWEGEIN,NETHERLANDS
[3] ST ANTONIUS HOSP,DEPT PATHOL,NL-3430 EM NIEUWEGEIN,NETHERLANDS
关键词
lung cancer; chest wall invasion; surgery; survival characteristics;
D O I
10.1136/thx.51.8.846
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Background - The optimum operative procedure for lung cancer with chest wall invasion (T3) remains controversial. In this study results of en bloc resection and extrapleural dissection are reviewed to determine survival characteristics. Methods - Between 1977 and 1993 125 patients underwent surgery for primary non-small cell lung cancer with chest wall invasion. Patients with superior sulcus tumours, metastatic carcinomas, synchronous tumours, or recurrences were excluded. Extrapleural dissection was performed in 73 patients and en bloc resection (range 1-4 ribs) in 52. Resection was regarded as complete in 86 and incomplete in 39 patients. Actuarial survival time was estimated and risk factors for late death were identified. Results - Hospital mortality was 3.2% (n = 4). Estimated mean five year survival was 24% for all hospital survivors (n = 121), 11% for patients with incomplete resection, and 29% for patients having a complete resection. In patients who underwent complete resection mediastinal lymph node involvement and intrapleural tumour spill worsened the prognosis. Patients with adenocarcinoma had a better chance of long term survival. No relationship was found between survival and age, type of operative procedure, depth of chest wall invasion, and postoperative radiotherapy. Conclusions - Both operative procedures show reasonable survival results. Incomplete resection, mediastinal lymph node involvement, and intrapleural tumour spill adversely influence survival.
引用
收藏
页码:846 / 850
页数:5
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