小细胞肺癌的手术治疗

Surgical Treatment of Small Cell Lung Cancer

1962到1983年22年间共手术治疗小细胞肺癌50例,其中27例切除(包括4例姑息切除),1例手术死亡。手术切除后4例5年以上健在(其中3例10年健在)。剖胸探查者无5年健在病例。Ⅰ期患者的5年生存率为17.6％,10年生存率为11.8％;Ⅱ期无2年以上生存者;Ⅲ期仅1例10年以上健在。无淋巴结转移的预后优于有转移者。症状期超过半年者切除率甚低。凡术前病理已证实为小细胞未分化癌,尤其是中心型。不适于手术治疗。作者认为辅助放疗和化疗,确能延长患者的生存期,故根治术后皆应辅助放疗和化疗,以期提高疗效。

Surgical operation was performed in 50 patients with SCLC during the period of 1962-1983 in Tianjin Cancer Hospital. Resections were carried out in 27 of these patients with one operative death. Four of 26 patients who survived surgical intervention were living 5 years of more postoperatively, including 3 who were living more than 10 years. There was no 5-year survival in 23 cases who had thoracotomy only. Of the patients who underwent resection the 5-year survival rate of Stage Ⅰ cases was 17.6% (3/17 cases), and 10-year survival rate 11.8％ (2/17 cases). There was no 2-year survivals in Stage Ⅱ patients; and only one patient in Stage Ⅲ was living and well for more than 10 years. The prognosis was better in patient with negative lymph node than that with positive nodes. The resection rate was very low when the duration of symptoms was more than 6 months. In situations when the dignosis of carcinoma was established before operation especially the lesion belonging to the central type, operative treatment was not indicated. The authors believe that adjuvant radiotherapy and/or chemotherapy could prolong the survival of patients and that adjuvant therapy after radical resection is mandatory.