Chest Wall Invasion in Carcinoma of the Lung: Therapeutic and Prognostic Implication
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概要
- 論文の詳細を見る
38 patients with lung cancer whose tumor was staged T_3 after surgical exploration because of direct chest wall invasion were studied. Of these, 18 patients underwent en bloc chest wall resection along with the lung (Group I), and the other 20 patients received an extrapleural dissection (Group II). The ages ranged from 42 to 78, with the median of 59.9 years. 32 were male and 6 were female. Histologically, the tumors were epidermoid carcinoma in 18 patients, adenocarcinoma in 11, large cell carcinoma in 7, adenosquamous cell carcinoma in 1, blastoma in 1 and others in 1. All patients had T_3 tumors. 21 had N_0 disease, 8 had N_1, 8 had N_2 and 1 had N_3. There were 4 with M_1 disease (intrapulmonary metastasis). If there was no evidence of invasion to the chest wall, a trial of extrapleural dissection was attempted on patients with a tumor attached to the parietal pleura. If any resistance was encountered, en bloc resection of the chest wall and lung was performed. The 5 year survival rate of 38 patients reviewed was 41%. Patients in Group II tended to show a better survival rate than those in Group I (44.4% vs. 37%, statistically not significant). Patients who underwent a complete resection showed a significantly better survival rate than those who underwent an incomplete resection (57% vs. 14.3% at 5 years). The survival rate of the patients with N_0 or N_1 disease tended to be better than that of the patients with N_2 disease. Patients with squamous cell carcinoma or large cell carcinoma tented to survive longer than those with adenocarcinoma. We concluded that en bloc resection of the chest wall or an extrapleural dissection can be performed with a reasonable expectation of long-term survival for patients with lung cancer having attached to the parietal leura. The importance of a complete resection regardless of the extent of the chest wall resection is emphasized.
- 北里大学の論文
- 1993-12-31
著者
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Yoshimura Hirokuni
Department of Thoracic Surgery, Kitasato University School of Medicine
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Ishihara Akira
Department of Thoracic & Cardiovascular Surgery, School of Medicine, Kitasato University
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SHINADA Jun
Departments of Thoracic and Cardiovascular Surgery, kitasato University School of Medicine
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Abe Yoshiaki
Department of Thoracic Surgery, Kitasato University School of Medicine
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Yoshimura Hirokuni
Departments Of Thoracic And Cardiovascular Surgery Kitasato University School Of Medicine
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Yoshimura Hirokuni
Department Of Thoracic And Cardiovascular Surgery Kitasato University Faculty Of Medicine
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Yoshimura Hirokuni
Department Of Thoracic And Cardiovascular Surgery
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Shinada Jun
Department Of Thoracic And Cardiovascular Surgery Kitasato University School Of Medicine
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Shinada Jun
Departments Of Thoracic And Cardiovascular Surgery Kitasato University School Of Medicine
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Ishihara A
Department Of Thoracic And Cardiovascular Surgery Kitasato University School Of Medicine
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Abe Yoshiaki
Department Of Thoracic Surgery Kitasato University School Of Medicine
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Koh Takamasa
Department of Thoracic and Cardiovascular Surgery, Kitasato University School of Medicine
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Ishihara Akira
Department Of Prosthodontics
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Abe Yoshiaki
Department Of Neurosurgery Jikei University School Of Medicine
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Koh Takamasa
Department Of Thoracic And Cardiovascular Surgery Kitasato University School Of Medicine
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Ishihara Akira
Department Of Agricultural Engineering Faculty Of Agriculture Tottori University
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Ishihara Akira
Department of Agiricultural Engineering, Faculty of Agriculture, Tottori University
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