Ｔ４進行肺癌に対する外科治療成績の検討 [in Japanese] Results of surgical treatment for T4 lung cancer. [in Japanese]
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教室において外科治療が施行されたT4肺癌75例の成績を検討した. T4切除例全体の5生率は10.5%であった. 生存率に最も関与する因子はN因子であり, 5生率はNOで38.2%, N1で6.3%, N2で3.5%, N3で5生例なく, NOとN2の間に有意差を認めた. 3年以上生存例は6例あり, 左房・気管分岐部・大血管などの単独臓器浸潤例であった. 一方, 癌性胸膜炎症例には長期生存例はなく, その手術適応の決定には慎重を要すると思われた.
In this study, survival curves and background factors affecting prognosis of resected T4 lung cancer were reviewed. A total of 738 patients with primary lung cancer, including 75 cases of T4 lesion, were surgically treated at Kanazawa University Hospital from January 1973 through June 1989.<BR>The cumulative 5-year survival rate after operation for all 67 cases of T4 lesion was 10.5%. Of these 67 cases, 28 cases which had curative operation showed no significant prolonged survival when compared to another 39 cases which resulted in non-curative operation.<BR>The background factor which was most concerned with the survival rate was the N factor. The 5-year survival rates according to N factor were as follows: T4NO; 38.2%, T4N1; 6.3%, T4N2; 3.5%, T4N3; nil. There was significant difference of survival rates between T4NO and T4N2.<BR>Three-year survival was obtained in 6 patients with invasion to the following: left atrium in 2 cases, carina in 2, superior vena cava in 1 and intra-pericardial pulmonary artery in 1. There was no prolonged survival in the cases of pleuritis carcinomatosa.<BR>It is possible that aggressive surgical treatment may yield long survival in T4 cases having invasion to solitary structure, such as left atrium and carina. However, it seems that decision on operative indications for cases of pleuritis carcinomatosa requires considerable circumspection.
Haigan 30(6), 827-832, 1990
The Japan Lung Cancer Society