目的:评估非小细胞肺癌合并单发脑转移患者接受外科治疗的有效性.方法:分析行脑部和胸部病灶联合切除的非小细胞肺癌单发脑转移患者的临床及随访资料.结果:21例患者进行了单发脑转移病灶切除和后续的肺癌根治术,18例(86%)患者有纵隔淋巴结转移,其中N1淋巴结阳性8例,N2淋巴结阳性10例.中位生存期32个月(95%置信区间15～49个月),1、2和5年生存率分别为70%、43%、22%.对可能影响预后的指标进行单因素分析,提示淋巴结转移是影响预后的危险因素(P=0.002).结论:对于非小细胞肺癌单发脑转移的患者,在保证病灶完全切除和手术耐受性的前提下,宜对胸部和脑部病灶同时采取积极的外科治疗策略,以获得最佳疗效.%Objective: To assess the efficacy on surgical management of non -small-cell lung cancer with solitary brain metastasis. Methods: Retrospective cohort study was conducted including clinical and follow -up data of the surgically treated patients with primary lung cancerand solitary brain metastasis between 2001 and 2011. Results: Twenty-one patients were treated with pulmonary resection and neurosurgical intervention . Eighteen patients (86%) were presented with mediastinal lymph nodes metastases , among which eight cases were in Nl stage, ten in N2 stage. Median survival time was 32 months (95% confidence interval; 15-49 months) and the 1-, 2-, 5-year survival ratewas 75% , 43% , 22% , respectively. The univariate analysis indicated lymph node metastasis was a prognostic risk factor ( P = 0. 002) . Conclusion: Taking the feasibility and compatibility into con -sideration , aggressive therapy including pulmonary resection and neurosurgical intervention should be recommended for non-small-cell lung cancer with solitary brain metastasis to achieve better prognosis .
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