肺转移瘤的外科治疗(附106例报告)

目的；探讨肺转移瘤外科治疗的指征，术前评价、手术方法及影响预后的因素。方法：对１０６例肺转移瘤的临床资料进行回顾性分析。结果：经手术治疗的肺转移瘤１０６例，其中转移性癌８６例，转移性肉瘤２０例，二者５年生顾率分别为１９．８％和２０％，以原发肿瘤乳腺癌、头颈部癌、泌尿系癌及骨肉瘤的肺转移预后较好，５年生存率分别为３３．３％，２７．３％，２０％及３３．３％。全组１年，３年，５年和１０年生存率分别为８３

Surgical management for pulmonary metastases(106 cases report)

Aim:To review the experience of surgical treatmen tof pulmonary metastased.Clinical material and method:From 1961 to 1997,118 resections for pulmonary metastases were performed in 106 patients,86 with carcinoma and 20 with sarcoma. The surgical procedures included 73 wedge resections,44 lobectomies and 1 pneumonectomy.Result:The surgical morbidity was 4.2%,and there was no operative mortality.The overall 5-year survival rate was 19.8% for patients with carcinoma,and 20% for those with sarcoma.For various sites of primary malignancies their 5-year survival was quite different.The better outcomes ranged in the groups of metastases from breast cancer,head and neck carcinoma,urinary tract cancer and osteosarcoma,which were 33.3%,27.3%,20%,and 33.3%,respectively.The 5-year survival for metastases from melanoma,oesophageal and gastric cardiac carcinoma was very poor. Conclusion:We emphasize the importance of a thorough evaluation for metastases,an strict indication in selecting patients,and a careful exploration.The combination of several significant individual factors was the best indicator for evaluating the postoperative long-time survival.A planned postoperative adjuvant chemotherapy and/or radiotherapy would play a more important role in the treatment of pulmonary metastases.