臨床外科69巻12号

2014年11月発行

特集 外科切除適応の境界領域—Borderline resectable cancerへの対応 がん種別の治療指針

肺癌

著者： 中島崇裕¹ 吉野一郎¹

所属機関： ¹千葉大学大学院呼吸器病態外科学

ページ範囲：P.1325 - P.1329

【ポイント】

◆切除不能な肺癌に対する明確な定義はなく，技術的切除可能性は外科チームの経験や技量に左右される．

◆臨床ⅢA期N2非小細胞肺癌に対し外科切除単独療法は勧められない．治療法選択には多職種での協議が推奨される．

◆T4N0-1非小細胞肺癌に対する隣接臓器合併切除は考慮してもよいが，合併症率が高く適応判断には注意を要する．

参考文献

1）Silvestri GA, Gonzalez AV, Jantz MA, et al：Methods for staging non-small cell lung cancer：Diagnosis and management of lung cancer, 3rd ed：American College of Chest Physicians evidence-based clinical practice guidelines. Chest 143：e211S-250S, 2013

2）Ramnath N, Dilling TJ, Harris LJ, et al：Treatment of stage Ⅲ non-small cell lung cancer：Diagnosis and management of lung cancer, 3rd ed：American College of Chest Physicians evidence-based clinical practice guidelines. Chest 143：e314S-340S, 2013

3）National Comprehensive Cancer Network. Non-Small Cell Lung Cancer （Version 4.2014）. http://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf （Accessed July 10, 2014）

4）Albain KS, Swann RS, Rusch VW, et al：Radiotherapy plus chemotherapy with or without surgical resection for stage Ⅲ non-small-cell lung cancer：a phase Ⅲ randomised controlled trial. Lancet 374：379-386, 2009

5）Patel AP, Crabtree TD, Bell JM, et al ：National patterns of care and outcomes after combined modality therapy for stage ⅢA non-small-cell lung cancer. J Thorac Oncol 9：612-621, 2014

6）Steger V, Walker T, Mustafi M, et al：Surgery on unfavourable persistent N2/N3 non-small-cell lung cancer after trimodal therapy：do the results justify the risk? Interact Cardiovasc Thorac Surg 15：948-953, 2012

7）Riquet M, Mordant P, Fabre-Guillevin E, et al：Long-term survival with surgery as part of a multimodality approach for N3 lung cancer. Eur J Cardiothorac Surg 44：1117-1122, 2013

8）Steger V, Walles T, Kosan B, et al：Trimodal therapy for histologically proven N2/3 non-small cell lung cancer：mid-term results and indicators for survival. Ann Thorac Surg 87：1676-1683, 2009

9）Nakajima T, Yasufuku K, Yoshino I：Current status and perspective of EBUS-TBNA. Gen Thorac Cardiovasc Surg 61：390-396, 2013

10）Detterbeck FC, Postmus PE, Tanoue LT：The stage classification of lung cancer：Diagnosis and management of lung cancer, 3rd ed：American College of Chest Physicians evidence-based clinical practice guidelines. Chest 143：e191S-210S, 2013

11）Kozower BD, Larner JM, Detterbeck FC, et al：Special treatment issues in non-small cell lung cancer：Diagnosis and management of lung cancer, 3rd ed：American College of Chest Physicians evidence-based clinical practice guidelines. Chest 143：e369S-399S, 2013

12）Watanabe S, Asamura H, Miyaoka E, et al：Results of T4 surgical cases in the Japanese Lung Cancer Registry Study：should mediastinal fat tissue invasion really be included in the T4 category? J Thorac Oncol 8：759-765, 2013

13）Yildizeli B, Dartevelle PG, Fadel E, et al：Results of primary surgery with T4 non-small cell lung cancer during a 25-year period in a single center：the benefit is worth the risk. Ann Thorac Surg 86：1065-1075, 2008

14）Stella F, Dell'Amore A, Caroli G, et al：Surgical results and long-term follow-up of T（4）-non-small cell lung cancer invading the left atrium or the intrapericardial base of the pulmonary veins. Interact Cardiovasc Thorac Surg 14：415-419, 2012

15）Galvaing G, Tardy MM, Cassagnes L：Left atrial resection for T4 lung cancer without cardiopulmonary bypass：technical aspects and outcomes. Ann Thorac Surg 97：1708-1713, 2014

16）Collaud S, Waddell TK, Yasufuku K, et al：Thoracic aortic endografting facilitates the resection of tumors infiltrating the aorta. J Thorac Cardiovasc Surg 147：1178-1182, 2014

17）Shin S, Park JS, Shim YM, et al：Carinal resection and reconstruction in thoracic malignancies. J Surg Oncol, 2014 （in press）

18）Sun Y, Zheng H, Chen Q, et al：Triple plasty of bronchus, pulmonary artery, and superior vena cava for non-small cell lung cancer. Ann Thorac Surg 95：420-424, 2013

19）Collaud S, Waddell TK, Yasufuku K, et al：Long-term outcome after en bloc resection of non-small-cell lung cancer invading the pulmonary sulcus and spine. J Thorac Oncol 8：1538-1544, 2013