Radical surgery is not a panacea for all lung cancer
Time:2009-11-04 20:52 Author:admin Hits:
Lung cancer in the primary tumor is an hour distant metastasis can occur even if a lung cancer, "cured" of surgery, there will be about 20% of patients had local recurrence or distant metastasis, two lung cancer surgery 30-40% of patients after lead to local recurrence or distant metastasis, three after lung cancer surgery more than 50% of the patients with local recurrence or distant metastasis, clinical, we see more of a distant metastasis.
Even if the early stage of lung cancer may also occur after surgical resection of local recurrence and distant metastasis. In recent years, lung cancer is a systemic disease of the concept has been accepted medical workers. Thus, treatment of lung cancer can not just focus on the local treatment, we must always bear in mind of lung cancer is a systemic disease that requires surgery, internal medicine, radiotherapy Branch multidisciplinary comprehensive treatment.
The United States Society of Clinical Oncology President emphasized that "almost all malignant tumors are subject to multi-disciplinary treatment", put forward oncology, thoracic surgery, Radiotherapy, Pathology, respiratory physicians need to join together for the diagnosis of lung cancer patients to develop scientific and rational treatment of program. We are Capital University of Medical Center of lung cancer treatment in recent years, multidisciplinary treatment is adherence to the principles of diagnosis and treatment.
In addition to surgical treatment of lung cancer, "the knife", the fact there are radiotherapy, chemotherapy, targeted therapy, Chinese medicine and other treatment. There are a wide range of clinical applications in recent years, gamma knife, argon-helium cryoablation, radiofrequency ablation, cryotherapy, and thermotherapy, photodynamic therapy and many other local physical treatment. However, each treatment has its own indications and must not blindly listen to promoters of the hype and watch some obvious cure by surgery in patients with early stage lung cancer have been misled by false advertising.
Breast cancer surgeon must be based on the specific conditions of lung cancer patients and clinical staging, integrated, scientific and rational application of existing local and systemic treatment, in order to achieve clinical cure or prolong survival, improve patient quality of life purposes.
The current multidisciplinary treatment modalities of lung cancer include: surgery + chemotherapy, surgery + targeted, targeted chemotherapy, radiofrequency ablation + chemotherapy, radiofrequency ablation + targeted, chemotherapy + radiotherapy + targeting a variety of combination treatment. In short, the treatment of lung cancer is not a disciplinary matter, we must emphasize multidisciplinary treatment, the focus on the extension of lung cancer survival, but also the emphasis on the quality of life of patients and give greater clinical benefit in patients with lung cancer.
In recent years, with a new generation of chemotherapeutic drugs and molecular targets for drug development and application of multi-disciplinary treatment modalities, as well as the development of lung cancer has been markedly improved, the overall five-year survival rate increased to 15%, and 80 years 8% of Comparing significant progress has been made.
Even if the early stage of lung cancer may also occur after surgical resection of local recurrence and distant metastasis. In recent years, lung cancer is a systemic disease of the concept has been accepted medical workers. Thus, treatment of lung cancer can not just focus on the local treatment, we must always bear in mind of lung cancer is a systemic disease that requires surgery, internal medicine, radiotherapy Branch multidisciplinary comprehensive treatment.
The United States Society of Clinical Oncology President emphasized that "almost all malignant tumors are subject to multi-disciplinary treatment", put forward oncology, thoracic surgery, Radiotherapy, Pathology, respiratory physicians need to join together for the diagnosis of lung cancer patients to develop scientific and rational treatment of program. We are Capital University of Medical Center of lung cancer treatment in recent years, multidisciplinary treatment is adherence to the principles of diagnosis and treatment.
In addition to surgical treatment of lung cancer, "the knife", the fact there are radiotherapy, chemotherapy, targeted therapy, Chinese medicine and other treatment. There are a wide range of clinical applications in recent years, gamma knife, argon-helium cryoablation, radiofrequency ablation, cryotherapy, and thermotherapy, photodynamic therapy and many other local physical treatment. However, each treatment has its own indications and must not blindly listen to promoters of the hype and watch some obvious cure by surgery in patients with early stage lung cancer have been misled by false advertising.
Breast cancer surgeon must be based on the specific conditions of lung cancer patients and clinical staging, integrated, scientific and rational application of existing local and systemic treatment, in order to achieve clinical cure or prolong survival, improve patient quality of life purposes.
The current multidisciplinary treatment modalities of lung cancer include: surgery + chemotherapy, surgery + targeted, targeted chemotherapy, radiofrequency ablation + chemotherapy, radiofrequency ablation + targeted, chemotherapy + radiotherapy + targeting a variety of combination treatment. In short, the treatment of lung cancer is not a disciplinary matter, we must emphasize multidisciplinary treatment, the focus on the extension of lung cancer survival, but also the emphasis on the quality of life of patients and give greater clinical benefit in patients with lung cancer.
In recent years, with a new generation of chemotherapeutic drugs and molecular targets for drug development and application of multi-disciplinary treatment modalities, as well as the development of lung cancer has been markedly improved, the overall five-year survival rate increased to 15%, and 80 years 8% of Comparing significant progress has been made.
Of lung cancer is divided into central type of lung cancer and peripheral lung cancer, central type of lung cancer tumor T staging may help doctors understand the location of lesions to help thoracic surgeons decided to remove the scope of hand surgery. Preoperative fiberoptic bronchoscopy biopsy in addition to adopting a clear pathological types of lung cancer, but also can clearly observe the invasion of tumor extent, help to determine the scope of surgical resection and removal, is critical for opening parts of the central type of bronchial lung cancer is particularly important. Even if the peripheral type of lung cancer can also be an effective bronchoscopic Shabu reviewed and bronchoscopy fluid cytological examination to be diagnosed, but also through transbronchial lung biopsy and lymph node biopsy to obtain pathological diagnosis. Now a lot of Thoracic Surgeons Medical University Hospital training program has already fiberoptic bronchoscopy technology, as a routine. Chinese Medical Association of Thoracic and Cardiovascular Surgery Branch has fiberoptic bronchoscopy microscopic examination of lung cancer patients as a routine examination prior to the project.
The chest CT for lung cancer, the sensitivity and specificity of mediastinal lymph nodes 50%, meaning that the chest CT prompted mediastinal lymph node, in fact, nearly half of it is not accurate, what we call false positive and false-negative. For the planned surgical treatment of locally advanced non-small cell lung cancer, chest CT and chest, such as PET may be prompted to have mediastinal lymph node metastasis before surgery is best carried out by video-mediastinoscopy was able to confirm mediastinal lymph node biopsy, especially in the chest CT and PET tips contralateral mediastinal lymph node metastasis possible cases should be TV mediastinoscopy.
Cancer Center, the vast majority of foreign norms are: a set of video-mediastinoscopy in lung cancer, mediastinal lymph node metastasis occurs, then abandon the surgery instead of conventional chemotherapy and radiotherapy and other conservative treatment. My thoracic surgeon targeted at a single mediastinal lymph node metastasis in non-small cell lung cancer, the majority of a selective surgical treatment, so video-mediastinoscopy is not widespread in our country carried out only in some large specialist hospitals and university centers in lung cancer.
Video-mediastinoscopy only in the chest and neck cut a small incision, through the removal of mediastinal lymph nodes for inspection mediastinoscopy Pathology. If the pathology report of the clinical review of mediastinal lymph nodes have not been transferred, thoracic surgeon, is scheduled on the regular line of open lung resection; if mediastinal lymph node pathology report, we are the end of surgery, push back to the wards for patients with two-cycle operation pre-operative chemotherapy.
There are several surgical method of lung cancer surgery?
As the medical science, modern anesthesiology, surgical equipment and technology, the development of minimally invasive thoracic surgery, lung surgery in the comprehensive treatment of lung cancer early and middle position and the value of more and more attention. Of lung cancer with video-assisted thoracic surgery and minimally invasive thoracic surgery techniques to carry out the development, the video-assisted thoracic small incision minimally invasive surgery, such as pulmonary wedge resection, lobectomy, the pleural effusion of unknown causes pleural biopsy and pleurodesis technique has been generally carried out in the country. Can say with certainty: I phase, Ⅱ period and part of a high degree of choice Ⅲ A non-small cell lung cancer patients may benefit from surgery.
The chest CT for lung cancer, the sensitivity and specificity of mediastinal lymph nodes 50%, meaning that the chest CT prompted mediastinal lymph node, in fact, nearly half of it is not accurate, what we call false positive and false-negative. For the planned surgical treatment of locally advanced non-small cell lung cancer, chest CT and chest, such as PET may be prompted to have mediastinal lymph node metastasis before surgery is best carried out by video-mediastinoscopy was able to confirm mediastinal lymph node biopsy, especially in the chest CT and PET tips contralateral mediastinal lymph node metastasis possible cases should be TV mediastinoscopy.
Cancer Center, the vast majority of foreign norms are: a set of video-mediastinoscopy in lung cancer, mediastinal lymph node metastasis occurs, then abandon the surgery instead of conventional chemotherapy and radiotherapy and other conservative treatment. My thoracic surgeon targeted at a single mediastinal lymph node metastasis in non-small cell lung cancer, the majority of a selective surgical treatment, so video-mediastinoscopy is not widespread in our country carried out only in some large specialist hospitals and university centers in lung cancer.
Video-mediastinoscopy only in the chest and neck cut a small incision, through the removal of mediastinal lymph nodes for inspection mediastinoscopy Pathology. If the pathology report of the clinical review of mediastinal lymph nodes have not been transferred, thoracic surgeon, is scheduled on the regular line of open lung resection; if mediastinal lymph node pathology report, we are the end of surgery, push back to the wards for patients with two-cycle operation pre-operative chemotherapy.
There are several surgical method of lung cancer surgery?
As the medical science, modern anesthesiology, surgical equipment and technology, the development of minimally invasive thoracic surgery, lung surgery in the comprehensive treatment of lung cancer early and middle position and the value of more and more attention. Of lung cancer with video-assisted thoracic surgery and minimally invasive thoracic surgery techniques to carry out the development, the video-assisted thoracic small incision minimally invasive surgery, such as pulmonary wedge resection, lobectomy, the pleural effusion of unknown causes pleural biopsy and pleurodesis technique has been generally carried out in the country. Can say with certainty: I phase, Ⅱ period and part of a high degree of choice Ⅲ A non-small cell lung cancer patients may benefit from surgery.
Lung resection and mediastinal lymph node dissection is currently the most common lung cancer, surgical resection. Pulmonary resection of lung cancer accounts for about 70%.
Bronchial sleeve lobectomy is mainly aimed at forming a special set of central type lung cancer, bronchoscopy prompted bronchial tumors were located in or violation of leaf openings. Intraoperative frozen section examination of bronchial stump delivery has become a routine.
Pneumonectomy, particularly right pneumonectomy gradually reduced in recent years, for senior citizens and low lung function in patients with lung cancer is more we must be cautious.
Local resection: including pulmonary segmental resection and wedge resection. In recent years, video-assisted thoracoscopic partial lung resection to elderly to bring survival benefit in patients with early stage lung cancer.
Bronchial sleeve lobectomy is mainly aimed at forming a special set of central type lung cancer, bronchoscopy prompted bronchial tumors were located in or violation of leaf openings. Intraoperative frozen section examination of bronchial stump delivery has become a routine.
Pneumonectomy, particularly right pneumonectomy gradually reduced in recent years, for senior citizens and low lung function in patients with lung cancer is more we must be cautious.
Local resection: including pulmonary segmental resection and wedge resection. In recent years, video-assisted thoracoscopic partial lung resection to elderly to bring survival benefit in patients with early stage lung cancer.
