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[巨大肿块型肺癌的外科治疗结果及预后因素]

[Result of surgical treatment and prognostic factors in giant mass lung cancer].

作者信息

Xu Bao-bin, Gao Wen, Chen Chang, Wei Ning, Zheng Hui, Zhou Ying, Zhang Rong-xuan

机构信息

Shanghai Pulmonary Disease Hospital, Shanghai 200433, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2007 Aug;29(8):632-5.

Abstract

OBJECTIVE

To investigate the role of surgery in the treatment of giant mass lung cancer and to analyze prognostic factors affecting surgical result.

METHODS

From August 1992 to August 2005, the clinical data of 137 patients with giant mass lung cancer ( > or =8 cm in diameter) were retrospectively reviewed. 122 cases had radical resection with 63 lobectomies, 48 pneumonectomy and 11 other resection modes, the remaining 15 patients underwent palliative resection. The prognostic factors including sex, tumor size, p-TNM stage, T stage, N stage, histological types and operation extent were analyzed with SPSS 13.0 software. The survival rate was calculated by Kaplan-Meier method and logrank was used for comparing survival difference. Univariate and multivariate prognostic factors for survival were analyzed by Cox proportional hazard regression model.

RESULTS

The overall 1-, 3- and 5-year survival rate was 76.0%, 49.2% and 40.1%, respectively. Sex (P = 0.001), p-TNM stage (P = 0.001), N stage (P = 0.042), surgical approach (P = 0.026) and T stage (P = 0.006) were found to be prognostic factors in Cox univariate analysis. p-TNM stage (P = 0.001) were identified as an independent prognostic factor in Cox multivariate analysis.

CONCLUSION

p-TNM stage is the crucial prognostic factor in surgical treatment for giant mass lung cancer. Strict selection of candidate for resection and complete resection may be helpful in improving survival in patient with giant mass lung cancer.

摘要

目的

探讨手术在巨大肿块型肺癌治疗中的作用,并分析影响手术效果的预后因素。

方法

回顾性分析1992年8月至2005年8月期间137例巨大肿块型肺癌(直径≥8 cm)患者的临床资料。122例行根治性切除,其中肺叶切除63例,全肺切除48例,其他切除方式11例,其余15例行姑息性切除。采用SPSS 13.0软件分析性别、肿瘤大小、p-TNM分期、T分期、N分期、组织学类型及手术范围等预后因素。采用Kaplan-Meier法计算生存率,用logrank检验比较生存差异。通过Cox比例风险回归模型分析生存的单因素和多因素预后因素。

结果

总体1年、3年和5年生存率分别为76.0%、49.2%和40.1%。Cox单因素分析显示,性别(P = 0.001)、p-TNM分期(P = 0.001)、N分期(P = 0.042)、手术方式(P = 0.026)及T分期(P = 0.006)为预后因素。Cox多因素分析确定p-TNM分期(P = 0.001)为独立预后因素。

结论

p-TNM分期是巨大肿块型肺癌手术治疗的关键预后因素。严格筛选手术候选者并完整切除肿瘤可能有助于提高巨大肿块型肺癌患者的生存率。

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