老年肺癌患者的外科治疗

Surgical treatment for lung cancer in the elderly

我科 1 995年 1月至 2 0 0 2年 1 1月外科手术治疗的 70岁以上老年患者 70例 ,其中 ,男 6 4例 ,女 6例 ,年龄 70～ 82岁 ,平均 72岁 ;鳞癌 5 2例 ,腺癌 1 4例 ,小细胞未分化癌 2例 ,其他类型 2例 ;手术切除 6 6例 (94 .2 8% ) ,其中全肺切除 1 2例 ,肺叶切除 5 3例 ,楔形切除 1例 ;术后TNM分期 ,Ⅰ期 4例 ,Ⅱa期 1 2例 ,Ⅱb期 2 7例 ,Ⅲa期 2 3例 ,Ⅲb期 4例 ;术后发生并发症 2 1例 (30 .0 % ) ,无围手术期死亡 ,术后 1、3、5年生存率分别为 75 .0 %、34.7%、2 7.0 %。分析认为 ,年龄不是手术禁忌 ,在严格掌握手术适应证、充分术前准备和积极处理术后并发症的基础上 ,可取得满意的临床疗效。

From Jan.1995 to Nov. 2002,70 lung cancer patients over 70 years old received surgical treatment in our department. There were 64 males and 6 females, aging 70 to 82 and averaging 72. Pathologically, there were 52 cases of squamous cell carcinoma, 14 adenocarcinoma, 2 small cell carcinoma, and 2 others. Pulmonary resection, pneumonectomy, lobectomy and segmentectomy were performed in 66 cases, 12 cases, 53 cases and 1 case, respectively. The total resection rate was 94.28%. The pathological TNM classification were p stageⅠ4 cases,stage Ⅱa 12 cases,stage Ⅱb 27 cases,stage Ⅲa 23 cases and stage Ⅲb 4 cases. Twenty one patients developed various complications after operation with an incidence of 30.0%; no early mortality was found. The 1,3 and 5 year survival rates were 75.0%, 34.7% and 27.0%, respectively. From this study, it is concluded that senility is not an absolute contraindication for surgery. A well pre surgery preparation and post operation aggressive management can obtain a satisfactory clinical outcome.