Thomas P, Massard G, Sielezneff I, Morati N, Giudicelli R, Garbe L, Reboud E, Fuentes P
Service de Chirurgie Thoracique, Hôpital Sainte-Marguerite, Marseille.
Rev Mal Respir. 1992;9(5):531-7.
Data from 452 patients who underwent pulmonary resection for a non small cell bronchogenic carcinoma from 1980 to 1985 were analysed retrospectively. The operative mortality rate was 5.5%. Mortality was significantly increased in patients who underwent enlarged resections for T4 tumors (20%; p < or = 0.05), and in patients who were 70 years and older (12.8%; p < or = 0.05). The overall 5-years survival rate was 32.7% at 5 years. Prognosis in patients who were 70 years and older was similar to that in younger patients. No difference in survival was observed in patients with lymph node metastases with regard to the operative procedure (pneumonectomy versus lobectomy). Survival in patients without lymph node metastases who underwent a lobectomy was similar to those who underwent a conservative resection. Prognostic significance of the histologic cell type and the tumor formula (pTNM) was assessed by multivariable analysis. There were statistically significant differences between squamous cell carcinoma and both adenocarcinoma (p < or = 10(-5)) and undifferentiated carcinoma (p < or = 0.01). This study confirmed the validity of the TNM classification (4th ed) for the accurate prognosis evaluation. Lymph node involvement appeared to be the most pejorative factor (p < or = 10(-5)).
对1980年至1985年间因非小细胞支气管源性癌接受肺切除术的452例患者的数据进行了回顾性分析。手术死亡率为5.5%。接受T4肿瘤扩大切除术的患者死亡率显著增加（20%；p≤0.05），70岁及以上患者死亡率也显著增加（12.8%；p≤0.05）。5年总生存率为32.7%。70岁及以上患者的预后与年轻患者相似。在有淋巴结转移的患者中，观察到手术方式（全肺切除术与肺叶切除术）对生存率无差异（p值）。接受肺叶切除术的无淋巴结转移患者的生存率与接受保守切除术的患者相似。通过多变量分析评估了组织学细胞类型和肿瘤公式（pTNM）的预后意义。鳞状细胞癌与腺癌（p≤10⁻⁵）和未分化癌（p≤0.01）之间存在统计学显著差异。本研究证实了TNM分类（第4版）对准确预后评估的有效性。淋巴结受累似乎是最不利的因素（p≤10⁻⁵）。
