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Abstract：
BACKGROUND: This study aimed to investigate predictors of thoracic aortic invasion in lung cancer patients using preoperative clinical and imaging characteristics and elucidate surgical outcomes in cases of aortic invasion.
METHODS: Of the 4751 lung cancer patients who underwent surgery at our hospital, we included 126 (6.8%) who underwent left-sided surgery and in whom tumor appeared to be in contact with the thoracic aorta on preoperative imaging. The patients were divided into two groups: group A, 23 patients (18%) who underwent combined aortic resection (+); group B, 103 patients (82%) who did not undergo combined aortic resection (-).
RESULTS: The percentage of aortic invasion for tumor diameter <3 cm, 3-4 cm, 4-5 cm, 5-7 cm, and >7 cm was 0%, 13%, 23%, 16%, and 35%, respectively. The percentages of aortic invasion were 27%, 16%, and 0% for tumor localization in the upper division, S6, and S10, respectively. Multivariate analysis revealed that aortic depression due to tumor or loss of fatty tissue between tumor and mediastinum in the chest CT significantly predicted aortic invasion (odds ratio = 23.83, 16.66). Group A demonstrated significantly more blood loss, longer operative time, prolonged hospital stay, and increased percentage of recurrent nerve palsy (13%) compared to group B. The 1-, 3-, and 5-year survival rates for patients in group A were 53.4%, 24.3%, and 24.3%, respectively.
CONCLUSIONS: If the chest CT of a patient demonstrates aortic depression due to tumor or loss of fatty tissue between tumor and mediastinum, aortic complications should be considered when planning surgery.
METHODS: Of the 4751 lung cancer patients who underwent surgery at our hospital, we included 126 (6.8%) who underwent left-sided surgery and in whom tumor appeared to be in contact with the thoracic aorta on preoperative imaging. The patients were divided into two groups: group A, 23 patients (18%) who underwent combined aortic resection (+); group B, 103 patients (82%) who did not undergo combined aortic resection (-).
RESULTS: The percentage of aortic invasion for tumor diameter <3 cm, 3-4 cm, 4-5 cm, 5-7 cm, and >7 cm was 0%, 13%, 23%, 16%, and 35%, respectively. The percentages of aortic invasion were 27%, 16%, and 0% for tumor localization in the upper division, S6, and S10, respectively. Multivariate analysis revealed that aortic depression due to tumor or loss of fatty tissue between tumor and mediastinum in the chest CT significantly predicted aortic invasion (odds ratio = 23.83, 16.66). Group A demonstrated significantly more blood loss, longer operative time, prolonged hospital stay, and increased percentage of recurrent nerve palsy (13%) compared to group B. The 1-, 3-, and 5-year survival rates for patients in group A were 53.4%, 24.3%, and 24.3%, respectively.
CONCLUSIONS: If the chest CT of a patient demonstrates aortic depression due to tumor or loss of fatty tissue between tumor and mediastinum, aortic complications should be considered when planning surgery.
摘要：
背景：本研究旨在使用术前临床和影像学特征研究肺癌患者胸主动脉侵犯的预测因素，并阐明主动脉侵犯病例的手术结果。
方法：在我院接受手术治疗的4751例肺癌患者中，我们纳入了126例(6.8%)患者,这些患者接受了左侧手术,在术前成像时肿瘤似乎与胸主动脉接触.将患者分为两组:A组,23例（18%）行联合主动脉切除术（+）；B组，103例（82%）未接受联合主动脉切除术（-）。
结果：肿瘤直径<3cm时，主动脉侵犯的百分比，3-4厘米，4-5厘米，5-7厘米，>7厘米为0%，13%,23%,16%,35%,分别。主动脉侵犯的百分比为27%，16%,上师肿瘤定位为0%，S6和S10。多因素分析显示，胸部CT中肿瘤引起的主动脉压低或肿瘤与纵隔之间的脂肪组织丢失可显著预测主动脉侵犯（比值比=23.83、16.66）。A组表现出明显更多的失血，更长的手术时间，住院时间延长,与B组相比，复发性神经麻痹的百分比增加（13％）1-，3-,A组患者的5年生存率为53.4%,24.3%,和24.3%，分别。
结论：如果患者的胸部CT显示由于肿瘤或肿瘤和纵隔之间的脂肪组织丢失引起的主动脉压低，计划手术时应考虑主动脉并发症.
方法：在我院接受手术治疗的4751例肺癌患者中，我们纳入了126例(6.8%)患者,这些患者接受了左侧手术,在术前成像时肿瘤似乎与胸主动脉接触.将患者分为两组:A组,23例（18%）行联合主动脉切除术（+）；B组，103例（82%）未接受联合主动脉切除术（-）。
结果：肿瘤直径<3cm时，主动脉侵犯的百分比，3-4厘米，4-5厘米，5-7厘米，>7厘米为0%，13%,23%,16%,35%,分别。主动脉侵犯的百分比为27%，16%,上师肿瘤定位为0%，S6和S10。多因素分析显示，胸部CT中肿瘤引起的主动脉压低或肿瘤与纵隔之间的脂肪组织丢失可显著预测主动脉侵犯（比值比=23.83、16.66）。A组表现出明显更多的失血，更长的手术时间，住院时间延长,与B组相比，复发性神经麻痹的百分比增加（13％）1-，3-,A组患者的5年生存率为53.4%,24.3%,和24.3%，分别。
结论：如果患者的胸部CT显示由于肿瘤或肿瘤和纵隔之间的脂肪组织丢失引起的主动脉压低，计划手术时应考虑主动脉并发症.
