肺癌的外科手术治疗精品.ppt

* Lung cancer is staged according to three parameters: tumour (T), lymph nodes (N) and metastatic involvement (M).1 For each of these, x indicates that the value cannot be assessed and 0 indicates that no evidence of the parameter is found. Additional stages are outlined below. Tumour stages: TIS: carcinoma in situ (confined to airway lining) T1-T4: ranging from tumour 3 cm in greatest dimension through to tumour of any size that invades the mediastinum, heart, great vessels, trachea, oesophagus, vertebral body or carina. Lymph node stages: N1: metastasis to ipsilateral peribronchial and/or ipsilateral hilar lymph nodes and intrapulmonary nodes involved by direct extension of primary tumour N2: metastasis to ipsilateral mediastinal and/or subcarinal lymph node(s) N3: metastasis to contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph node(s). Distant metastasis stages: M1: distant metastasis present. The schematic diagram shows examples of some tumour stages: Early stage 0 (carcinoma in situ): tumour is confined to the airway lining stage IA (T1 N0 M0): tumour has spread to nearby lung tissue but has not reached the main bronchus Localised stage IIB (T2 N1 M0/T3 N0 M0): tumour has reached main bronchus and local lymph nodes or direct local invasion into chest wall, diaphragm, mediastinal pleura or parietal pericardium Advanced stage IIIB (T4 Any N M0/Any T N3 M0): tumour has invaded chest wall, trachea and the contralateral lymph nodes stage IV (Any T Any N M1): distant metastasis present in the brain. Fewer than 30% of patients present with stage I or II disease.2 References Mountain CF. Chest 1997; 111: 1710-1717. Ihde DC. N Engl J Med 1992; 327: 1434-1441. * 51171右肺上叶中分化鳞癌（李成友） 肺癌的外科手术治疗 肺癌手术治疗是目前最可靠，最有效的治疗方法。  历史回顾 目前外科手术发展现状。 * NSCLC分期与生存期之间的关系 分期 TNM 占总体比率（%） 5年生存率 IA T1N0M0 ～10 67 IB T2N0M0