Surgical Treatment for Lung Metastases from Colorectal Cancer

大腸癌の肺転移は大腸癌手術症例の2.4%が切除対象であり, overallの5年生存率は50%, 10年生存率は43%であった. 根治切除58例の5年生存率は53%であるのに対し, 姑息3例や非切除19例の50%生存期間はそれぞれ1年3カ月, 1年と予後不良であった (p<0.01). 予後因子としては, 術前血清CEA値, 肺転移の個数, 胸腔内洗浄細胞診, 縦隔リンパ節転移があげられた. 診断方法として, ヘリカル胸部CTによる転移巣の数と部位の診断向上があり, 切除方法としては, 特にYAG-Laserを用いた部分切除が有用で, 残肺再切除や肝・肺切除等適応拡大に寄与していると考えられた.

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