47例老年肺癌中的多原发癌治疗和预后临床分析

A Clinical Reseach on Multiple Primary Lung Cancer in 47 Senile Patients

目的:研究老年肺癌中多原发癌的临床治疗和预后。方法:回顾性复习281例经病理证实的老年肺癌,对其中47例多原发癌进行临床分析。结果:本组老年多原发癌占16.7%(47/281),多原发肺癌4.9%(14/281);多重癌异时性78.7%(37/47),同时性21.3%(10/47);双原发癌41例(87.2%),三原发癌5例(10.6%),五原发癌1例(2.1%)。初原发癌平均生存期10.6年,首、重癌间隔平均6.5年;重癌切除率61.7%(29/47),术后平均生存5.5年,>非手术者的2.2年。结论:原发癌治疗后生存3年以上的患者,将增加重复癌的发生。因此,对重复癌需要长期终身追踪,并尽可能手术切除治疗,以提高生存期。

Objective:To study the treatment and prognosis of multiple primary cancers(MPC)or multiple primary lung cancers(MPLC)in elderly patients.Methods:47patients with MPC which were from281patients of lung cancer confirmed by pathology and cytology in our department were retrospectively reviewed and analyzed in clinical material.Results:The inci-dence of the MPC comprised16.7%(47/281)and of the MPLC comprised4.98%(14/281);The metachronous MPCwas78.7%(37/47)and synchronous MPC was21.3%(10/47);41patients(87.2%)had double primary cancers,5patients(10.6%)had three primary cancers and one(2.1%)had five primary cancer;the mean survival of the first primary tumor(index tumor)was10.6years;the mean interval between index tumor and MPC was6.5years;the rate of MPC resected was61.7%(29/47),mean survival of MPC resected was5.5years longer than2.2years in unresected MPC.Conclusion:The patients surviving treatment of primary cancers require lifelong screening for MPLC,because of the MPC or MPLC are increasing in long surviving patients,the resection should be recommended whenever possible for good prognosis.