Hayashi Y, Tomiyama I, Ishii H, Ishiwa N, Itoh H, Nakayama H, Ogawa N, Takanashi Y
1st Department of Surgery, Yokohama City University of Medecine, Japan.
Kyobu Geka. 2000 Oct;53(11):919-25.
To evaluated the new UICC TNM classification, we investigated the prognosis of patients who had resection of non-small cell lung cancer. A total of 670 patients with non-small cell lung cancer underwent complete resection and pathologic staging of the disease from 1987 to 1994. The survivals were calculated with Kaplan-Meier methods on the basis of overall deaths, and the survival curves were compared by Logrank test. The 5-year survival rates were 84.6% in stage I A (n = 187), 65.2% in stage I B (n = 177), 41.5% in stage IIA (n = 24), 46.7% in stage IIB (n = 100), 25.6% in stage IIIA (n = 139), 25.8% in stage IIIB and 0 in stage IV. There were significant differences in survival between stage I A and stage I B as well as between stage IIB and stage IIIA. However, there were no significant differences in survival between stage IIA and stage IIB, between stage IIIA and stage IIIB. No significant difference in survival was observed among patients with T1N1M0, T2N1M0 and T3N0M0 (43.9%). In stage IIIB, the patients with pm1 N2 disease (8.9%) had more poorly prognosis than the patients with pm1N0 disease (70.1%) and pm1N1 (38.9%) disease. We concluded that the dividing stage I into A and B categories and placing T3N0M0 in stage II and placing pm2 in stage IV were adequate. In the patients with satellite tumors within the primary lobe of the lung, we think that a new category depended on the N-category is necessary.
为评估新的国际抗癌联盟（UICC）TNM分类法，我们调查了接受非小细胞肺癌切除术患者的预后情况。1987年至1994年期间，共有670例非小细胞肺癌患者接受了疾病的完全切除及病理分期。采用Kaplan-Meier法根据总死亡人数计算生存率，并通过对数秩检验比较生存曲线。I A期（n = 187）患者的5年生存率为84.6%，I B期（n = 177）为65.2%，II A期（n = 24）为41.5%，II B期（n = 100）为46.7%，IIIA期（n = 139）为25.6%，IIIB期为25.8%，IV期为0。I A期与I B期以及II B期与IIIA期之间的生存率存在显著差异。然而，II A期与II B期之间、IIIA期与IIIB期之间的生存率无显著差异。T1N1M0、T2N1M0和T3N0M0患者的生存率无显著差异（43.9%）。在IIIB期，pm1 N₂疾病患者（占8.9%）的预后比pm1N0疾病患者（占70.1%）和pm1N1疾病患者（占38.9%）更差。我们得出结论，将I期分为A和B两类、将T3N0M0归为II期以及将pm2归为IV期是合适的。对于肺叶内有卫星灶的患者，我们认为需要根据N分期建立一个新的类别。
