46例肺转移癌的手术治疗及预后因素分析

Surgical treatment for 46 patients with pulmonary metastases and regressive analysis of related prognostic factors

目的 :探讨肺转移癌的外科手术治疗效果与影响预后的相关因素。方法 :46例经手术治疗的肺转移癌患者 ,常规开胸手术 30例 ,电视辅助胸腔镜下手术 1 6例。对患者随访 ,用Kaplan Meier法计算生存率 ,绘出生存曲线 ;用Logistic回归分析评定影响预后的相关因素。结果 :本组病例三、五年生存率分别为 33 .8%和 1 5 .8% ;Logistic多因素回归分析显示纵隔淋巴结转移和多叶转移是肺转移癌重要的预后不利因素。结论 :对有选择的肺转移癌患者采取手术治疗可治愈部分患者 ;肺多叶转移灶和转移癌伴纵隔淋巴结转移者预后不良 ,手术治疗应该慎重选择。

Purpose:To evaluate the significance of surgery for pulmonary metastases and investigate the adverse factors of prognosis.Methods:Forty six patients with pulmonary metastases were studied. Operation was performed through conventional thoracotomy ( in 30 patients) and video assisted thoracoscopic surgical techniques (in 16 patients). Patients were followed up. Survival rate was calculated with Kaplan Meier method. Logistic regressive analysis was done to identify adverse prognostic factors.Results:Three year and five year survival rates were 33.8% and 15.8% respectively. Logistic multivariate regressive analysis revealed that multiple lobes metastases and metastases with lymph nodal metastases were adverse factors for prognosis.Conclusions:Surgery might cure some selected patients with pulmonary metastases. Multiple lobes metastases and metastases with mediastinal lymph nodal metastases are indicators of poor prognosis.