外科治疗在肺转移瘤综合治疗中的价值

Value of surgical treatment of pulmonary metastases in multimodality therapy

目的探讨外科治疗手段在肺转移瘤多学科综合治疗中的价值。方法对27例肺转移瘤病人的临床资料和综合治疗效果进行回顾性分析。结果27例肺转移瘤病人手术后经病理证实与原发肿瘤相同。均获随访,随访率100.0%。1a和3a生存率为96.3%和74.6%,中位生存期38个月。合并脑和骨转移8例病人,1a和3a生存率为75.0%和31.3%,中位生存期24个月。再次出现肺转移瘤病人9例,再次发生率为33.3%,其中8例施行2次手术,1例施行3次手术,1a和3a生存率分别为88.9%和77.8%,中位生存期为48个月。全组无严重并发症,无手术死亡。结论外科治疗手段在肺转移瘤的多学科综合治疗中可有效的提高长期生存率。对于同时存在其它部位转移病灶的肺转移瘤病人,只要其它器官的转移瘤得到有效控制,不应作为外科治疗的禁忌症。对再次复发的肺转移瘤病人外科治疗仍可有效的提高病人的生存时间。

To study the value of surgical treatment of pulmonary metastases in multimodality therapy. The clinical data and multimodality therapy effect of 27 patients of pulmonary metastases were analysed retrospectively. The pathological diagnosis of 27 pulmonary metastases were all alike to primary tumor.27 patients of pulmonary metastases were follow up, the follow-up rate is 100.0%. The 1-year and 3-year survival were 96.3% and 74.6% for the 27 patients. The median survival time was 38 months. The 1-year and 3-year survival were 75.0% and 31.3%, median survival time was 24 months, for the 8 patients of pulmonary metastases with brain metastases and bone metastases. 9 patients of pulmonary metastases have recurred after first metastatectomy, the 8 patients were underwent second resection and 1 patient was underwent third resection, the 1-year survival rate and 3-year survival rate were 88.9% and 77.8%, median survival time was 48 months. There was no serious complication and operative mortality. [Conclusion] surgical treatment can prolong the survival time effectively in the multimodality therapy of pulmonary metastases. The surgical treatment is not contraindication for multiple metastases, if other metastasis tumor could be treated effectively. surgical treatment can prolong effectively the survival time of recurrences patient after metastatectomy in the multimodality therapy.