<原著>非小細胞肺癌の外科治療

Abstract

最近10年間に当院で切除した非小細胞肺癌209例(切除率29.3%)を検討した。男性126例, 女性83例で, 平均年齢61.8±8.8歳, 36歳から85歳に及んでいた。術後病理組織学的病期分類では, I期121例, II期22例, III_A期43例, III_B期14例, IV期9例だった。全症例の5年生存率は54%で, 術後1カ月以内の死亡は3例(1.4%)のみだった。病期別5年生存率は, I期71%, II期22%, III_A期38%, III_B期36%, IV期25%だった。手術根治度別では, 根治例66%, 相治例46%, 相非例55%, 絶非例19%だった。組織型別5年生存率では扁平上皮癌と腺癌の間に有意差は認められなかった。高齢者(70歳以上)症例は41例(19.6%)あったが, その3年生存率, および5年生存率は, それぞれ58%, 40%で, 非高齢者群と統計学的に有意差は認められなかった。また, 気管支形成術, 拡大合併切除術, 縮小手術についても, 少数例ながら経験し, ほぼ満足できる成績が得られた。

Two hundred and nine patients with non-small cell lung cancer underwent surgical treatment from January, 1978 to December, 1987 at the Kochi Municipal Hospital. There were 126 men and 83 women, varying in age from 36 to 85 years. The post-surgical stage distribution was as follows : 121 patients with Stage I, 22 with Stage II, 43 with Stage III_A, 14 with Stage III_B and 9 with Stage IV. The 5 year survival rate was 54% for all patients and only 3 patients of them (1.4%) died within the first month following operation. The 5 year survival rate was 71% for Stage I, 22% for Stage II, 38% for Stage III_A, 36% for Stage III_B and 25% for Stage IV. The 5 year survival rate was 66% for absolutely curative operatin, 46% for relatively curative operation, 55% for relatively noncurative operation and 19% for absolutely noncurative operation. This series have 41 patients (19.6%) over 70 years old, and the 3 year and the 5 year survival rates for this high age group were 58% and 40%, respectively. Statistically, there was no significant difference in survival rate between this high age group and the younger group. Our successful experiences of the bronchoplastic procedures, extended resections and limited operations were also reported.