J.Jpn. Surg. Soc.. 83(9): 979-982, 1982
Report on the annual meeting
LIMITATION OF SURGICAL TREATMENT OF ADVANCED LUNG CANCER
－From the Viewpoint of Extended Combined Resection－
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*) Department of Surgery, National Sanatorium Matsudo Hospital, Matsudo, Japan Hiroyuki Nishiyama*), Isamu Tengan*), Tomoji Matsuyama*), Yasuhiro Miyazaki**) |
An extended combined resection was performed on 96 of the cases. In 83 out of these 96 cases, excluded of 13 cases undergone panpleuro-pneumonectomy, the organs resected combinedly were as follows : 1) parietal pleura and chest wall in 49 cases, 2) diaphragma in 4 cases and 3) mediastinal structure in 46 cases (including the pericardium in 18 cases, left atrium in 14 cases, superior vena cava in 2 cases, aorta in 3 cases and oesophagus in 9 cases). Combined resection involved two or more organs in 17 cases, totalling to 99 organs in 83 cases.
1) In cases of extended combined resection, relatively long survivors were observed in cases of squamous cell carcinoma with lower N-factor (No,N1) undergone relative curative operation.
2) Prognosis was relatively favourable in cases with chest wall resection and those with pericardium resection. Even among cases with left atrium resection there was some which survived for three and a half years postopratively.
These results encourage us to performe aggressive surgery for these type of organ invasion.
3) Indication of panpleuro-pneumonectomy for lung cancer associated with malignant pleural effusion should be determined with caution. We believe that its indication should be confined to cases with slight pleural dissemination which can tolerate operation in terms of cardiopulmonary function.
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