Development of early lung cancerFrom 1933, the world's first surgical treatment of early lung cancer, so far, early lung cancer surgery has
Development of early lung cancer
From 1933, the world's first surgical treatment of early lung cancer, so far, early lung cancer surgery has gone through 80 years of history. In 30s, the standard operation of early lung cancer is pneumonectomy; 50s, early lung lobectomy gradually replace pneumonectomy.
With the popularization of CT, the enhancement of people's awareness of health examination and the development of lung cancer screening project in various countries, more and more early lung cancer (early stage I) can be detected early. According to the size of the tumor, there is no hilar and mediastinal lymph node metastasis and lung metastasis, lung cancer is divided into stage I, II, III and IV, the stage can be divided into type A and type B, early lung cancer clinically refers to 1 a (pulmonary lesions less than 2cm, no lymph node metastasis).
With the process of population aging intensifies, early lung cancer in patients over 80 years old, usually because of intolerance and lose the chance of radical lobectomy. 30 years ago, 80 years early standard operation for patients with lung cancer was lobectomy. Until today, the International Association for the study of lung cancer, the American society, China Institute, Department of thoracic surgery, Department of thoracic surgery, Professor Zhi Xiuyi presided over the formulation of the "primary lung cancer diagnosis and treatment standards", the standard operation of early lung cancer is still lobectomy. What kind of surgical resection of early lung cancer is a hot topic in the field of global Department of thoracic surgery.
In 1997, CT is just emerging, the researchers tried to use sublobar resection instead of standard lobectomy, results showed lobectomy after local recurrence and distant metastasis and 5 year survival were inferior lobectomy; subgroup analysis showed that the anatomy of pulmonary resection is better than pulmonary wedge resection, at stage I lung cancer refers to the lesion size is 3cm lung cancer.
The International Association for the study of lung cancer in 2007 promulgated the new staging method of lung cancer, I determine the stage a lung cancer lesion size is less than or equal to 2cm, according to the new staging of lung cancer lobectomy in Central Asia whether can let the benefit for patients with stage Ia cancer, the United States (1300 cases), Japan (1100 cases) in 2008 and 2007 respectively and the global multi center clinical study. Announced the preliminary results of their research will be at the end of October this year Australia Sydney at the fifteenth World Conference on lung cancer. The present study preliminary data show that in early than 2cm of lung adenocarcinoma, if the density of < solidified; 25%, the sublobar resection.
So far, China has had 10 years of early stage lung cancer treated with thoracoscopy. Before 2003, early lung cancer surgery was used in traditional thoracotomy, that is, to cut or cut the ribs, cut off the chest wall muscles. In 2003 after the advent of video-assisted thoracoscopy through clinical, single hole, two hole, four hole or holes can be the standard for early lung cancer lobectomy and thoracic lymph node dissection. For 20 years the American Thoracic mirror early clinical studies of lung cancer and multi group confirmatory data analysis: thoracoscopic lobectomy and open chest lung resection for the treatment of early lung cancer patients five year survival is. Thoracoscopic treatment of early lung cancer in 2006 has been written in the United States NCCN non-small cell lung cancer clinical guidelines.