Surgical Treatment of 143 Lung Cancer Cases by Sleeve Lobectomy
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摘要: 目的 :探讨支气管源性肺癌袖状肺叶切除术后预后生存影响因素。 方法 :采用袖状肺叶切除术治疗支气管源性肺癌143例,通过肿瘤注册和术后随访,采用寿命表法对随访结果进行Log-Rank统计处理,分析不同肿瘤分期对预后的影响因素。 结果 : 全组患者术后 PTNM 分期Ⅰ 期42 例(29.37% )和Ⅱ期66例(46.15%),Ⅲa 期32例(22.38%)和Ⅲb期3例(2.10%), 全组总 5 年生存率 47.20%,其中Ⅰ、Ⅱ、Ⅲ期5年生存率分别为77.30%、56.10%、20.56%;Ⅰ期和Ⅱ期5年生存率较Ⅲ期有明显差异(P<0.05),但Ⅰ期和Ⅱ期之间无显著差异(P>0.05)预后与淋巴结分期有关,73例(51.05%)N0期5年生存率为61.00%,而56例(39.16%) N1期5年生存率为45.00%,二者无明显差异;N2期14 例(9.79%)无1例5年生存,N0期、N1期5年生存率与N2期有明显差异(P<0.05)。结论:通过术前仔细筛选病例, 袖状肺叶切除术是治疗原发性肺癌N0和N1期病变的有效方法;对于N2期病变主张先进行多学科辅助治疗后再进行外科治疗。Abstract: Objective :To study the factors affecting the prognosis of patients with lung cancertreated by sleeve lobectomy. Methods :One hundred forty-three patients with lung cancer underwentsleeve lobectomy. All cases were followed up after surgery. The findings related to prognosis were ana-lyzed by the life table method. The Log-Rank test was used to analyze the relationship between differ-ent stages and the prognosis after sleeve lobectomy. Results :The cohort included 42 cases (29.37%) ofstage Ⅰ (ⅠA and ⅠB) disease, 66 cases (46.15%) of stage Ⅱ (ⅡA and ⅡB) disease, 32 cases(22.38%) of stage ⅢA disease and 3 cases (2.09%) of stage ⅢB disease. The overall 5-year survivalrate was 47.20%. The 5-year survival rate in stage Ⅰ, stage Ⅱ and stage Ⅲ was 77.3%, 56.1% and20.56%, respectively. There was a significant difference between stage Ⅰ and stage Ⅱ when comparedindividually to stage Ⅲ, but there was no difference between stage Ⅰ and stage Ⅱ. The prognosis wasrelated to the N staging. The results showed that the 5-year survival rate in N0 stage (73 cases,51.05%) and N1 stage (56 cases, 39.16%) was 61% and 45%, respectively. However, no patients with N2 stage (14 cases, 9.79%) survived more than 5 years. There was a significant difference in the 5-yearsurvival rate between N0, N1 and N2 stages. Conclusion :Sleeve lobectomy is an effective method fortreating stage N0 and N1 lesions of primary lung cancer after careful preoperative screening of the cases.Surgical treatment after multidisciplinary adjunctive therapy is recommended for patients with stage-N2 lesions.
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Keywords:
- Lung cancer /
- Sleeve lobectomy /
- PTNM staging /
- Prognosis
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