Shields T W, Yee J, Conn J H, Robinette C D
Ann Thorac Surg. 1975 Nov;20(5):501-10. doi: 10.1016/s0003-4975(10)64249-x.
In the completed adjuvant chemotherapy lung trials conducted by the Veterans Administration Surgical Group, the cell type was recorded in 2,341 of 2,349 curative resections; extent of lymph node involvement was known in all cases. Nodes were normal in 1,231 patients. Five- and ten-year survival computed by the life-table method was 33.7% and 20.4%, respectively. These rates were significantly greater than the 16.2% and 8.8% recorded in 1,118 patients whose nodes showed metastases. Among patients whose cell type was known, five-year survival in 484 with hilar node involvement was 17.4% and was not significantly different from 20.1% in 364 patients in whom only lobar nodes were involved. The survival was 8.9% in 268 patients with cancer in the mediastinal nodes; this was significantly worse than either of the aforementioned groups. A five-year survival of 26.8% in 1,482 patients with squamous cell carcinoma was greater than the 24.3% in 359 with adenocarcinoma and 22.4% in 500 with undifferentiated cell types, but the differences were not significant. Variations between these groups remained nonsignificant when nodes were normal and were of only borderline significance, at the 5% level, when they showed metastasis. When a curative resection has been accomplished, cell-type as classified in this study has little bearing on long-term survival, whereas the presence of node metastasis as well as its location is of the utmost importance.
在退伍军人管理局外科小组进行的已完成的辅助化疗肺癌试验中，2349例根治性切除病例中有2341例记录了细胞类型；所有病例的淋巴结受累程度均已知。1231例患者的淋巴结正常。采用生命表法计算的5年和10年生存率分别为33.7%和20.4%。这些比率显著高于1118例淋巴结有转移患者记录的16.2%和8.8%。在细胞类型已知的患者中，484例肺门淋巴结受累患者的5年生存率为17.4%，与仅叶淋巴结受累的364例患者的20.1%无显著差异。268例纵隔淋巴结癌患者的生存率为8.9%；这明显低于上述两组中的任何一组。1482例鳞状细胞癌患者的5年生存率为26.8%，高于359例腺癌患者的24.3%和500例未分化细胞类型患者的22.4%，但差异不显著。当淋巴结正常时，这些组之间的差异仍然不显著，而当淋巴结有转移时，差异仅在5%水平上具有边缘显著性。当完成根治性切除时，本研究分类的细胞类型对长期生存影响不大，而淋巴结转移的存在及其位置至关重要。
