【摘要】 目的探讨北京协和医院胸外科近15年外科治疗肺癌生存率变化的原因。方法回顾性分析1989年1月到2003年12月外科治疗肺癌1574例生存结果,按时间顺序分为两组,比较A组(1999-2003年)和B组(1989-1998年)生存率变化。结果A组和B组并发症分别为11．2％和19．2％,死亡率分别为1．06％和1．93％,差异有显著性(P<0．01)。A组和B组3年生仔率分别56．07％和42．35％,5年生存率分别38．99％和28．46％,差异有显著性(JP<O．0001)。Ⅰ期、Ⅱ期、ⅢA期生存率提高并有显著性差异,而ⅢB期、Ⅳ期生存率无显著差别。肺叶切除生存率提高明显,而开胸探查、局部肺切除、全肺切除及支气管袖状切除生存率差别不大。结论肺叶切除加系统淋巴结清扫是支气管肺癌手术治疗的标准方式;肿瘤切除后辅以铂类／第三代化疗药物综合治疗模式,初步证实能提高远期生存率。更多还原

【Abstract】 Objective: To investigate and evaluate improvement of lung cancer survival after surgical intervention in PUMC hospital during the last 15 years. Methods: From January 1989 to December 2003, 1574 lung cancer cases underwent surgical treatment and followed up. All cases in this series were divided into two groups according to time period: group A (1999-2003) and group B (1989-1998). The difference in the survival rate between groups A and B was compared. Results: The morbidity and mortality in group A was decreased significantly in comparison to group B (11.2% vs. 19.2%, 1.06% vs. 1.93%, respectively). However, the 3-year and 5-year survival rate was increased from 42.35% to 56.07%, and from 28.46% to 38.99%, respectively. A significant improvement in survival was observed in patients with stage I, n and mA, but not in those with stage MB and IV. Also, patients with lobectomy had more satisfactory results than those receiving exploratory thoracotomy, limited resection, pneumonectomy and sleeve resection. Conclusion: Lobectomy plus systematic mediastinal lymph nodes dissection has become the standard mode for resectable lung cancer. Combination of complete resection along with lymph nodal dissection, and postoperative adjuvant chemotherapy based on platinum/3rd generation chemotherapy medicine, has preliminarily been justified, proving an important approach for effective improvement in long-term survival of non-small cell lung carcinoma.更多还原