Application Of Surgical Treatment In Lung Metastases

【Objective】 Analyze and explore different surgical methods,the extent of lung resection,the length of the tumor-free period,whether the primary tumor is resected,whether the adjuvant treatment is performed after surgery,whether the lymph nodes are metastasized,and other factors that affect prognosis,for many different sources.Prognosis,diagnosis,and impact on postoperative survival of patients with lung metastases.【Methods】 This study retrospectively analyzed the clinical data of 49 patients who underwent surgery in the Department of Thoracic Surgery.Shandong Provincial Cancer Hospital,Shandong University from January 2010 to December 2013.The clinical data of the 49 patients in this study were improved and confirmed as postoperative pathology as lung metastases.The primary tumors in this case were from different case tissues.The most common primary tumors were the colorectal cancer,18 cases,followed by breast cancer,11 cases,endometrial cancer in 5 cases,and gastric cancer in 4 cases,thyroid cancer and soft tissue sarcoma,3 cases each,renal cell carcinoma and hepatocellular carcinoma,2 cases each,1 case of giant cell tumor of bone.The surgical procedure in all cases,the nature of resection of metastases,the extent of lung resection,and the length of no tumor interval,and the patient’s gender,age,whether the primary tumor was removed,the number and size of secondary tumors,lymph node metastasis,postoperative adjuvant therapy were analyzed statistically,and the SPSS24.0 statistics software was used to deal with it.The Kaplan-Meier method was used to analyze the prognosis and survival rate of patients after operation.The difference of survival rate between groups was compared by log-rank method.The Cox regression proportional risk model was used for multi-factor analysis.p≤ 0.05 is considered statistically significant.【Results】 In this study,a total of 49 patients were successfully treated by telephone follow-up and medical record data,and all were discharged after treatment.The postoperative follow-up period ranged from 1 month to 60 months in all patients.The 1-year survival rate of all patients in this study was 91.8%,the 3-year survival rate was 57.1%,and the 5-year survival rate was 28.6%.In the univariate analysis,gender,DFI,lung resection,lymph node metastasis,postoperative adjuvant therapy,primary tumor resection,and resection of lung metastases were all factors influencing the prognosis of patients,In the multivariate analysis,DFI,whether the primary tumor was resected,and whether the lymph node metastasis were independent factors that affected the prognosis and survival rate of patients.【Conclusion】 For single or multiple lung metastases from different sources,the complete resection of surgical treatment has an important impact on the prognosis and survival rate of patients.Therefore,surgical treatment has important positive significance for the treatment of lung metastases.At the same time,the size of the lung resection,the complete resection of metastases or the choice of palliative resection,the length of DFI,the presence or absence of lymph node metastasis,whether the primary tumor is removed and the subsequent adjuvant treatment will have an impact on the patient’s prognosis and long-term survival rate.Therefore,for patients with lung metastases,surgical treatment should be performed as much as possible in the absence of surgical contraindications,the extent of lung resection should be selected as much as possible to remove the lobes.The metastases of the lungs should be completely removed as much as possible,and appropriate adjuvant treatment should be performed for patients in need.