Nagai Kanji, Sohara Yasunori, Tsuchiya Ryosuke, Goya Tomoyuki, Miyaoka Etsuo
Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
J Thorac Oncol. 2007 Apr;2(4):282-6. doi: 10.1097/01.JTO.0000263709.15955.8a.
In the current TNM staging system revised in 1997 for lung cancer, intrapulmonary metastases (PM) are classified into two categories: PM1 (in the same lobe of the primary tumor), designated as T4; and PM2 (in a different lobe), as M1. There have been no large-scale analyses on PM in non-small cell lung cancer (NSCLC) patients. We collected data nationwide in Japan for 7408 lung cancer patients undergoing surgical resection during a single year, 1994. We analyzed the long-term survival of NSCLC patients to evaluate the prognostic impact of PM in relation to other prognostic factors.
Medical records of 6525 NSCLC patients undergoing surgical resection during a single year, 1994, were analyzed as a subset work of the Japanese Joint Committee of Lung Cancer Registry. The committee sent a questionnaire on outcome and clinicopathological profiles to 303 institutions.
There were 6080 PM0 (no PM), 317 PM1, and 128 PM2 patients. The 5-year survival rates were 55.1% for PM0 patients, 26.8% for PM1, and 22.5% for PM2 patients, respectively. The differences in survival between patients with PM0 and PM1 and between patients with PM0 and PM2 were significant (p < 0.001, respectively); the difference in survival was not significant between patients with PM1 and PM2 (p = 0.298). In R0 and N0 patients, survival differences were similar for PM0, PM1, and PM2 patients. Significant survival difference was detected between T3 and PM1 (p = 0.0317) and between PM1 patients and T4 patients excluding PM1 (p = 0.0083). The 5-year survival rates of PM2 patients and M1 patients excluding PM2 were 22.5% and 20.5%, respectively, and there was no significant difference between the groups (p = 0.434).
There was no significant survival difference between NSCLC patients with PM1 and PM2. The survival of patients with PM1 was between that of the T3 and T4 patients excluding PM1.
在1997年修订的现行肺癌TNM分期系统中，肺内转移（PM）分为两类：PM1（在原发肿瘤的同一肺叶内），归为T4；PM2（在不同肺叶），归为M1。目前尚无针对非小细胞肺癌（NSCLC）患者肺内转移的大规模分析。我们收集了1994年日本全国范围内7408例接受手术切除的肺癌患者的数据。我们分析了NSCLC患者的长期生存情况，以评估肺内转移相对于其他预后因素的预后影响。
作为日本肺癌登记联合委员会的一项子工作，我们分析了1994年接受手术切除的6525例NSCLC患者的病历。该委员会向303家机构发送了一份关于结局和临床病理特征的问卷。
有6080例PM0（无肺内转移）、317例PM1和128例PM2患者。PM0患者、PM1患者和PM2患者的5年生存率分别为55.1%、26.8%和22.5%。PM0与PM1患者之间以及PM0与PM2患者之间的生存差异具有显著性（p值分别<0.001）；PM1与PM2患者之间的生存差异无显著性（p = 0.298）。在R0和N0患者中，PM0、PM1和PM2患者的生存差异相似。在T3与PM1之间（p = 0.0317）以及PM1患者与排除PM1的T4患者之间（p = 0.0083）检测到显著的生存差异。PM2患者和排除PM2的M1患者的5年生存率分别为22.5%和20.5%，两组之间无显著差异（p = 0.434）。
PM1和PM2的NSCLC患者之间无显著的生存差异。PM1患者的生存率介于排除PM1的T3和T4患者之间。
