原发性气管癌44例临床分析

比较原发性气管癌手术与非手术治疗的疗效，探讨影响本病预后的因素。回顾性分析经组织学证实的４４例原发性气管癌病人的临床与随访资料。手术切除１８例；非手术治疗２６例（放疗采用钴６０或高能Ｘ线，靶区剂量为６０～７０Ｇｙ；化疗采用ＣＯＭＦ或ＡＭＦＰ方案４～６个疗程）。结果采用ＫａｐｌａｎＭｅｉｅｒ法计算其１、３、５年生存率，手术切除者分别为８３．３％、６６．７％和３３．３％，非手术治疗者分别为７３．１％、４２．３％和１５．４％。ｌｏｇｒａｎｋ检验显示无统计学意义，Ｐ＞０．０５。气管上段腺样囊性癌预后相对较好，治疗后５年内约有７７．３％病人死于肿瘤末控、复发或转移。结论：原发性气管癌手术与非手术者的预后似乎无明显差异，影响本病预后的因素主要为其发病部位和病理类型

Clinical Analysis of Primary Tracheal Carcinoma(Report of 44 Cases)

Aim:To evaluate the surgical result of primary tracheal carcinoma and its prognostic factors.Clinical material and method:Forty four patients with primary tracheal carcinoma were treated in our hospital from March 1971 to December 1990.There were 30 males and 14 females with a mean age of 49.3 years(range,26 to 69 years).Mean duration of the disease before treatment was 14 months(range,4 to 36 months).Preoperative chest radiographys showed a mass lesion in trachea in 39 patients(88.6%)and tracheal stenosis in 5(11.4%).19 patients had squamous carcinomas,8 had adencarcinomas,12 had adenoid cystic carcinomas and 5 had other types of carcinoma.The length of tumor was less than 1 cm in 16 patients,1 to 3cm in 19 and longer than 3cm in 9.The tumor located in the upper trachea in 9,the middle part of the trachea in 14 and the low part in 21.Surgical resection was performed in 18 patients and they all received postoperative chemoradiotherapy.The remain 26 patients received radiotherapy followed by chemotherapy.The operative approach was through neck in 7,neck plus partial median sternotomy in 2 and right thoracotomy in 9.Surgical procedures performed included wedge excision in 3,sleeve resection in 11 and carinal resection and reconstruction in 4.The mean length of resected trachea was 5.1cm(range,4 to 6 cm).Results:The operative mortality rate was 11.1%(2 of 18)and operative morbidity rate was 16.7% for surgical group.The hospital mortality rate was 3.8% and morbidity rate was 19.2% for non surgical group.The 1 year,3 year and 5 year survival rates were 83.3%,66.7% and 33.3% for surgical group and 73%,42.3% and 15.4% for non surgical group.There were no significant differences in concerning long term survival between two groups.Conclusion:The results of this study did not show significant difference in long term survival between surgical group and non surgical group.The site and pathological type of the tumor are related to the prognosis of primary tracheal carcinoma.