原发性肺癌侵犯胸壁的外科治疗

SURQICAL TREATMENT FOR ‘THE INVOLVEMENT OF CHEST WALL BY PRIMARY LUNG CANCER

本文报告了１０７例原发性肺癌侵犯胸壁的外科疗效，术后１年、３年、５年生存率分别为７３．８％、４５．５％、３０．７％。文章着重讨论了术前诊断与估计、手术方式的选择及胸壁重建原则和方法，认为这类病变大部为周围型肺癌，只要无远处转移，即使肿块巨大，伴有或不伴有助骨破坏仍可行根治性手术切除。文章分析了影响预后的主要因素：淋巴结有无转移，肺和胸壁切除有无肿瘤残留，尤其强调了根治性胸壁切除，区域淋巴结清除和综合治疗的重要性。

Surgical treatment of lung cancer invading the chest wall in 107 cases between 1984 to 1990 was reported.There were 96 male and ll female patients with an average age of 609 years. Chest pain was an initial symptom in 43. 7 %. The 1-、3-,5-,year survival rates after operation were 73.8%,45.5%and 30.7%,espectively. According to the lymph node (N)factor,there were signiflc ant differences in respective survival rates in the NO,N1,N2,cases.The authors discussed in stress the preoperative evaluation,operative procedure and chest wall reconstructi on. Statistical analysis of the factors iofluencing the pootoperative survival rate showed that the metastasis of lymph node in mediastinum,tumor cell remained in the resection margin and adjuvant therapy. Were the poor proghostic factors.