摘要
目的 :探讨纵隔淋巴结转移 (N2 )的非小细胞肺癌 (non smallcellcancer ,NSCLC)患者根治术后肿瘤复发的模式 ,为手术后采取有针对性的辅助治疗措施提供依据。方法 :回顾 96例根治性切除术后病理诊断为N2 肺癌患者的临床资料。术后 2年内每 6个月对患者进行随访复查 1次 ,监测肿瘤复发情况。计算复发率 ,应用 χ2 检验比较手术后放疗及化疗对肿瘤复发模式的影响。结果 :术后 2年内肿瘤复发率为 3 7 5 % ( 3 6/ 96) ,复发模式以转移性复发为主 ,占 77 78%( 2 8/ 3 6) ,多数为脑和肺转移 ( 64 2 9% ,18/2 8)。手术后放疗者的局部复发率为5 17% ( 3 / 5 8) ,而未施行放疗者的局部复发率为 2 3 68% ( 9/ 3 8) ,两者差异有统计学意义 ,P <0 0 5 ,OR =5 69;手术后化疗者与未化疗者相比 ,局部复发和转移性复发发生率差异无统计学意义 ,P >0 0 5。结论 :转移性复发是N2 非小细胞肺癌根治术后肿瘤复发的主要模式 ,手术后放疗可以减少N2 肺癌根治术后肿瘤的局部复发。
OBJECTIVE:To investigate the postoperative recurrence patterns in patients with resected stage Ⅲ (N 2 disease) non-small cell lung carcinoma (NSCLC). METHODS:Clinical data of ninety-six patients with NSCLC, who underwent radical surgery and were diagnosed to be with mediastinal lymph node metastasis (N 2 disease) determined by histopathologic examination,were reviewed.The patients were followed up and checked up every six months for two years to detect recurrence lesion. The rate of local recurrence and distant metastasis within two years were calculated. The impact of postoperative adjuvant therapy on local recurrence and distant metastasis was compared by χ2 test.RESULTS: The two-year recurrence rate was 37.5%(36/96).The main recurrence pattern was of distant metastasis (77.78%,28/36), and most patients were with brain and lung metastasis (64.29%,18/28).The local recurrence rate in patients with adjuvant radiotherapy was lower than that of patients without adjuvant radiotherapy (5.17% vs 23.68%, OR=569,P<0.05).There was no significant difference in local recurrence and metastatic recurrence of patients with and without adjuvant chemotherapy,P>0.05.CONCLUSION: Distant metastasis is main recurrence patterns of postoperative recurrence in patients with resected stage Ⅲ (N 2 disease) NSCLC. Adjuvant radiotherapy could decrease the local recurrence rate.[
出处
《肿瘤防治杂志》
2004年第7期720-722,共3页
China Journal of Cancer Prevention and Treatment
关键词
肺肿瘤/外科学
淋巴结
复发
淋巴转移
lung neoplasms/surgery
lymph nodes
recurrence
lymphatic metastasis
