亚肺叶切除术与肺叶切除术治疗老年磨玻璃结节的疗效比较

Comparison of Curative Effect between Sublobar Resection and Lobectomy on the Elderly with Ground-glass Opacities

目的总结分析亚肺叶切除术(肺段切除术、肺楔形切除术)与肺叶切除术对70岁以上老年磨玻璃结节的预后疗效。方法回顾2010年1月—2013年12月期间进行手术切除的243例70岁以上老年磨玻璃型肺癌患者。其中肺段切除术32例,肺楔形切除术112例,肺叶切除术99例,分析3组患者的远期预后。结果全组患者3年总生存率为84.3%;3组患者3年无病生存率(DFS)相似(肺段切除组96.3%、楔形切除组98.9%、肺叶切除组97.3%,P=0.42),3组患者3年总生存率(OS)相近(楔形切除组87.3%、肺段切除组87.9%、肺叶切除组85.3%,P=0.63)。结论 70岁以上老年磨玻璃结节型肺癌患者,亚肺叶切除术(肺段切除术、肺楔形切除术)能取得与肺叶切除术相似的远期预后,亚肺叶切除术可作为70岁以上老年磨玻璃结节可选择地根治性手术。

Objective To summarize and analyze the sublobar resection（segmentectomy of lung and pulmonary wedge resection） or lobectomy in the elderly at 70 and over 70 with lung ground-glass opacities（GGOs） and to evaluate the effects on the prognosis.Methods A retrospective analysis was made to the clinical data of 243 elderly patients at 70 and over70 undergoing surgical resections for lung cancer with GGOs;according to surgical strategy,32 cases were classified into segmentectomy group,99 cases into lobectomy group and 112 cases into wedge resection group;the long-term prognosis of the patients were analyzed.Results The 3-year overall survival（OS） was 84.3%;the 3-year disease free survival（DFS）in each of the 3 groups was similar（96.3%in segmentectomy group,98.9%in wedge resection group and 97.3%in lobectomy group,P=0.42）,as well as the 3-year OS in each of the 3 groups（87.3%in in wedge resection group,87.9%in segmentectomy group and 85.3%in lobectomy group,P=0.63）.Conclusions Sengmentectomy and wedge resection for lung cancer with GGOs can lead to similar long-term prognosis in elderly patients over 70 years old to lobectomy,they can be taken as the radical surgical treatment.