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Ngày xuất bản:
02/11/2020
Số lượt xem tóm tắt: 197
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Số lượt xem PDF: 135
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Trích dẫn bài báo
Quế, Đỗ K. ., & Quân, Đào H. . (2020). Vai trò phẫu thuật nạo hạch trong điều trị ung thư phổi không tế bào nhỏ có hạch N2. Tạp chí Phẫu thuật Tim mạch và Lồng ngực Việt Nam, 23, 17-24. https://doi.org/10.47972/vjcts.v23i.379
Vai trò phẫu thuật nạo hạch trong điều trị ung thư phổi không tế bào nhỏ có hạch N2
Nội dung chính của bài viết
Tóm tắt
Trong thời gian 10 năm từ năm 2004 tới năm 2014 có 94 bệnh nhân ung thư phổi không tế bào nhỏ có hạch trung thất đã được phẫu thuật tại bệnh viện Thống Nhất. 78 trường hợp cắt 1 thùy phổi chiếm tỉ lệ 83%, 2 trường hợp cắt 2 thùy phổi chiếm tỉ lệ 2,1%, cắt toàn bộ 1 bên phổi trong 3 trường hợp chiếm tỉ lệ 3,2%, 3 trường hợp mổ nội soi cắt thùy phổi chiếm tỉ lệ 3,2%, 8 trường hợp mổ thám sát sinh thiết u và hạch trung thất chiếm tỉ lệ 8,5%. Tất cả 94 bệnh nhân đều được hóa trị bổ trợ với phác đồ có platinum.
62 trường hợp phát hiện có hạch trung thất trước mổ trên chụp vi tính cắt lớp chiếm tỉ lệ 66,0%. 42 trường hợp hạch trung thất phát hiện có tế bào ung thư di căn trên mô bệnh học chiếm tỉ lệ 44,7%.
Kết quả sớm cho thấy không có tử vong do phẫu thuật. 1 trường hợp chảy máu sau mổ chiếm tỉ lệ 1,1%. Xẹp phổi do tắc đàm 1 trường hợp, tràn khí màng phổi kéo dài 2 trường hợp.
Thời gian sống thêm trung bình là 36 tháng, thời gian sống thêm không bệnh trung bình là 30,4 tháng. Tỉ lệ sống thêm 5 năm là 19,1%. Có sự khác biệt giữa nhóm bệnh nhân có hạch N2 có tế bào ung thư di căn và nhóm hạch N2 không có tế bào ung thư di căn về thời gian sống thêm 5 năm lần lượt là 14,3% và 23,1%.
Chi tiết bài viết
Từ khóa
Ung thư phổi không tế bào nhỏ, hoá trị bổ trợ, Resectable NSCLC, adjuvant chemotherapy.
Tài liệu tham khảo
1. Besse B, Chevalier TL (2008). Adjuvant Chemotherapy for Non–Small-Cell Lung Cancer: A Fading Effect? Journal of Clinical Oncology 26(31):5014-5017.
2. Betticher DC, Schmitz SH, Totsch M, et al (2003). Mediastinal lymph node clearance after Docetaxel-Cisplatin Neoadjuvant chemotherapy is pronogtic of survival in patient with stage IIIA pN2 Non small cell lung cancer: A multicenter phase II trial. J Clin Oncol 21: 1752-1759.
3. Bonomi M, Pilotto S, Milella M, Massari M (2011). Adjuvant chemotherapy for resected non-small cell lung cancer: future perspectives for clinical research. Journal of Experimental & Clinical Cancer Research. 30:115.
4. Bonomi P, Kim K, Fairclough D et al, (2000) Comparison of survival and quanlity of life in advanced non-small cell lung cancer
patients treated with two dose levels of paclitaxel combined with cisplatin versus etoposide with cisplatin: results of an Eastern Cooperative Oncology Group trial. J Clin Oncol 18(3):623-631.
5. Chatwani L, Cabebe L, Wakelee HA (2009). Adjuvant Treatment of Resected Lung Cancer. Proc Am Thorac Soc. 6: 194–200.
6. Conundrums in the management of lung cancer (2003). Challenges in lung cancer pathology. Am Soc Clin Oncol 2003, p164-169
7. Fabrice Andre F, Grunenwald D, Pignon JP, Dujon A, Pujol JL, Brichon PI, Brouchet L, Quoix E, Westeel V, Chevalier T. (2000). Survival of Patients With Resected N2 Non–Small-Cell Lung Cancer: Evidence for a Subclassification and Implications. Journal of Clinical Oncology, 18 (16): 2981-2989
8. Gajra A, Newman N, Gamble GP, Kohman LJ, Graziano SL. (2003). Effect of number of lymph nodes on outcome in patients with stage I non small cell lung cancer. J Clin Oncol 21: 1029-1034.
9. Hainaut P, Ma X, Lacas B, Tsao M et al. (2012). Lace bio pools analysis of the prognostic and predictive value of TP53 mutation in completely resected non small cell lung cancer. Abstract 1192PD ESMO.
10. Langer CJ, Mac Aleer CA, Bonjo CA et al, (2000). Paclitaxel by 1 hour infusion in combination with carboplatin in advanced non-small cell lung carcinoma. Eur J cancer 36(2):183-193.
11. Leong SS, Tan EH, Fong KW, et al. (2003). Randomized double blind trial of combined modality treatment with or without amifostin in unresectable stage II non small cell cancer. J Clin Oncol 21: 1767-1774.
12. Mac Manus MP, Hicks RJ, Mathews JP et al, (2003). Positron Emission tomography is superior to computed tomography scanning for response-assessment after radical radiotherapy
PHẪU THUẬT TIM MẠCH VÀ LỒNG NGỰC VIỆT NAM SỐ 23 - THÁNG 6/2018
24
odr chemotherapy in patients with non-small cell lung cancer. J Clin Oncol. 21:1285-1292
13. Malcolm M. DeCamp MM, Ashiku S, Thurer R. (2005) The Role of Surgery in N2 Non Small Cell Lung Cancer. Clin Cancer Res 2005;5033s 11(13 Suppl)
14. Misthos P, Sepsas E, Kokotsakis J, Skottis I, Lioulias A. (2008)The Significance of One-Station N2 Disease in the Prognosis of Patients With Nonsmall-Cell Lung Cancer. Ann Thorac Surg 86:1626 –31.
15. Ohta Y, Oda M, Wu J, Tsunezuka Y, Hiroshi M, Nonomura A, Watanabe G. (2001) Can tumors size be a guide for limitted sugical intervention in patients with peripheral NSCLC. J Thorac Cardiovasc Surg 122: 900 – 906.
16. Okada M, Yamagishi H, Satake S, Matsuoka H, Miyamoto Y, et al. (2000) Suvival related to lymph node involvement in lung cancer after sleeve lobectomy compared to pneumonectomy. J Thorac Cardiovasc Surg 119: 814 – 19.
17. Patel MI, Wakelee HA. (2011). Adjuvant chemotherapy for early stage non-small cell lung cancer. 1(45):1-4.
18. Rinaldi M, Crino L, Scagliotti GV et al, (2000). A three weeks schedule of gemcitabine-cisplatin in advanced non-small cell lung cancer with two different cisplatin dose levels: A phase II randomized trial. Ann Oncol 11(10):1295-1300.
19. Sandler AB, Numunaitis J, Denham C et al. (2000). PhaseIII trial of gemcitabine plus cisplatin versus cisplatin alone in patients with locally advanced or metastatic non-small-cell lung cancer. J Clin Oncol 18(1): 122-130
20. Schiller JH, Harrington D, Sandler A et al, (2000) Arandomized trial of four chemotherapy regimens in advanced non-small cell lung tumors. Proc Am Soc Clin Oncol 18:1a.
21. Sebastian A. Defranchi SA, Cassivi SD, Nichols FC, Allen MS, Shen KR, Deschamps C, Wigle DA. (2009) N2 Disease in T1 Non-Small Cell Lung Cancer. Ann Thorac Surg 88:924 –9.
22. Shapiro M (2012) The role of adjuvant chemotherapy in early stage and locally advanced non-small cell lung cancer. Cleveland clinic j of Med. 79(1): 42-45.
23. Shepherd F, Koschel G, von Pawel J et al, (2000). Comparison of Tirazone and cisplatin v. etoposide and cisplatin in advanced non-small cel lung cancer: final results of the international phase III CATAPULT II trial. Lung cancer 29(suppl 1):27.
24. Socinski MA (2003). A dressing the optimal duration of therapy in advanced, metastatic non small cell lung cancer. American society of clinical oncology p144-152
25. Srimuninimit V, (2000). A phase II study with carboplatin and paclitaxel plus amifostine in treatment of advanced non-small cell lung cancer: prelimentary report. Proc Am Soc Clin Oncol 18:524a.
26. Takiguchi Y, Nagao K, Nishiwaki Y et al, (2000). The final results of a randomized phase III trial comparing irrinotecan and cisplatin with vindesine and cisplatin in advanced non-small cell lung cancer. Lung cancer 29(suppl 1):28.
27. Vesselle H, Pugley M, Vallieres E, Wood DE. (2002) The impact of fluorodeoxyglucose F 18 positron-emission tomography on the sugical staging of NSCLC. J Thorac Cardiovasc Surg 124: 511-19.
28. Wakelee HA. (2010). Systemic therapy for patients with early-stage non-small cell lung cancer. Globan Resource for advancing cancer education.
2. Betticher DC, Schmitz SH, Totsch M, et al (2003). Mediastinal lymph node clearance after Docetaxel-Cisplatin Neoadjuvant chemotherapy is pronogtic of survival in patient with stage IIIA pN2 Non small cell lung cancer: A multicenter phase II trial. J Clin Oncol 21: 1752-1759.
3. Bonomi M, Pilotto S, Milella M, Massari M (2011). Adjuvant chemotherapy for resected non-small cell lung cancer: future perspectives for clinical research. Journal of Experimental & Clinical Cancer Research. 30:115.
4. Bonomi P, Kim K, Fairclough D et al, (2000) Comparison of survival and quanlity of life in advanced non-small cell lung cancer
patients treated with two dose levels of paclitaxel combined with cisplatin versus etoposide with cisplatin: results of an Eastern Cooperative Oncology Group trial. J Clin Oncol 18(3):623-631.
5. Chatwani L, Cabebe L, Wakelee HA (2009). Adjuvant Treatment of Resected Lung Cancer. Proc Am Thorac Soc. 6: 194–200.
6. Conundrums in the management of lung cancer (2003). Challenges in lung cancer pathology. Am Soc Clin Oncol 2003, p164-169
7. Fabrice Andre F, Grunenwald D, Pignon JP, Dujon A, Pujol JL, Brichon PI, Brouchet L, Quoix E, Westeel V, Chevalier T. (2000). Survival of Patients With Resected N2 Non–Small-Cell Lung Cancer: Evidence for a Subclassification and Implications. Journal of Clinical Oncology, 18 (16): 2981-2989
8. Gajra A, Newman N, Gamble GP, Kohman LJ, Graziano SL. (2003). Effect of number of lymph nodes on outcome in patients with stage I non small cell lung cancer. J Clin Oncol 21: 1029-1034.
9. Hainaut P, Ma X, Lacas B, Tsao M et al. (2012). Lace bio pools analysis of the prognostic and predictive value of TP53 mutation in completely resected non small cell lung cancer. Abstract 1192PD ESMO.
10. Langer CJ, Mac Aleer CA, Bonjo CA et al, (2000). Paclitaxel by 1 hour infusion in combination with carboplatin in advanced non-small cell lung carcinoma. Eur J cancer 36(2):183-193.
11. Leong SS, Tan EH, Fong KW, et al. (2003). Randomized double blind trial of combined modality treatment with or without amifostin in unresectable stage II non small cell cancer. J Clin Oncol 21: 1767-1774.
12. Mac Manus MP, Hicks RJ, Mathews JP et al, (2003). Positron Emission tomography is superior to computed tomography scanning for response-assessment after radical radiotherapy
PHẪU THUẬT TIM MẠCH VÀ LỒNG NGỰC VIỆT NAM SỐ 23 - THÁNG 6/2018
24
odr chemotherapy in patients with non-small cell lung cancer. J Clin Oncol. 21:1285-1292
13. Malcolm M. DeCamp MM, Ashiku S, Thurer R. (2005) The Role of Surgery in N2 Non Small Cell Lung Cancer. Clin Cancer Res 2005;5033s 11(13 Suppl)
14. Misthos P, Sepsas E, Kokotsakis J, Skottis I, Lioulias A. (2008)The Significance of One-Station N2 Disease in the Prognosis of Patients With Nonsmall-Cell Lung Cancer. Ann Thorac Surg 86:1626 –31.
15. Ohta Y, Oda M, Wu J, Tsunezuka Y, Hiroshi M, Nonomura A, Watanabe G. (2001) Can tumors size be a guide for limitted sugical intervention in patients with peripheral NSCLC. J Thorac Cardiovasc Surg 122: 900 – 906.
16. Okada M, Yamagishi H, Satake S, Matsuoka H, Miyamoto Y, et al. (2000) Suvival related to lymph node involvement in lung cancer after sleeve lobectomy compared to pneumonectomy. J Thorac Cardiovasc Surg 119: 814 – 19.
17. Patel MI, Wakelee HA. (2011). Adjuvant chemotherapy for early stage non-small cell lung cancer. 1(45):1-4.
18. Rinaldi M, Crino L, Scagliotti GV et al, (2000). A three weeks schedule of gemcitabine-cisplatin in advanced non-small cell lung cancer with two different cisplatin dose levels: A phase II randomized trial. Ann Oncol 11(10):1295-1300.
19. Sandler AB, Numunaitis J, Denham C et al. (2000). PhaseIII trial of gemcitabine plus cisplatin versus cisplatin alone in patients with locally advanced or metastatic non-small-cell lung cancer. J Clin Oncol 18(1): 122-130
20. Schiller JH, Harrington D, Sandler A et al, (2000) Arandomized trial of four chemotherapy regimens in advanced non-small cell lung tumors. Proc Am Soc Clin Oncol 18:1a.
21. Sebastian A. Defranchi SA, Cassivi SD, Nichols FC, Allen MS, Shen KR, Deschamps C, Wigle DA. (2009) N2 Disease in T1 Non-Small Cell Lung Cancer. Ann Thorac Surg 88:924 –9.
22. Shapiro M (2012) The role of adjuvant chemotherapy in early stage and locally advanced non-small cell lung cancer. Cleveland clinic j of Med. 79(1): 42-45.
23. Shepherd F, Koschel G, von Pawel J et al, (2000). Comparison of Tirazone and cisplatin v. etoposide and cisplatin in advanced non-small cel lung cancer: final results of the international phase III CATAPULT II trial. Lung cancer 29(suppl 1):27.
24. Socinski MA (2003). A dressing the optimal duration of therapy in advanced, metastatic non small cell lung cancer. American society of clinical oncology p144-152
25. Srimuninimit V, (2000). A phase II study with carboplatin and paclitaxel plus amifostine in treatment of advanced non-small cell lung cancer: prelimentary report. Proc Am Soc Clin Oncol 18:524a.
26. Takiguchi Y, Nagao K, Nishiwaki Y et al, (2000). The final results of a randomized phase III trial comparing irrinotecan and cisplatin with vindesine and cisplatin in advanced non-small cell lung cancer. Lung cancer 29(suppl 1):28.
27. Vesselle H, Pugley M, Vallieres E, Wood DE. (2002) The impact of fluorodeoxyglucose F 18 positron-emission tomography on the sugical staging of NSCLC. J Thorac Cardiovasc Surg 124: 511-19.
28. Wakelee HA. (2010). Systemic therapy for patients with early-stage non-small cell lung cancer. Globan Resource for advancing cancer education.