Chiang Tai-An, Chen Ping-Ho, Wu Pei-Fen, Wang Tsu-Nai, Chang Po-Ya, Ko Albert Min-Shan, Huang Ming-Shyan, Ko Ying-Chin
Department of Medical Technology, College of Medicine and Life Science, Chung-Hwa University of Medical Technology, Tainan, Taiwan.
BMC Cancer. 2008 Nov 7;8:324. doi: 10.1186/1471-2407-8-324.
This study used a large-scale cancer database in determination of prognostic factors for the survival of lung cancer subjects in Taiwan.
Total of 24,910 subjects diagnosed with lung cancer was analysed. Survival estimates by Kaplan-Meier methods. Cox proportional-hazards model estimated the death risk (hazard ratio (HR)) for various prognostic factors.
The prognostic indicators associated with a higher risk of lung cancer deaths are male gender (males versus females; HR = 1.07, 95% confidence intervals (CI): 1.03-1.11), males diagnosed in later periods (shown in 1991-1994 versus 1987-1990; HR = 1.13), older age at diagnosis, large cell carcinoma (LCC)/small cell carcinoma (SCC), and supportive care therapy over chemotherapy. The overall 5-year survival rate for lung cancer death was significantly poorer for males (21.3%) than females (23.6%). Subjects with squamous cell carcinoma (SQCC) and treatment by surgical resection alone had better prognosis. We find surgical resections to markedly increase 5-year survival rate from LCC, decreased risk of death from LCC, and no improved survival from SCC.
Gender and clinical characteristics (i.e. diagnostic period, diagnostic age, histological type and treatment modality) play important roles in determining lung cancer survival.
本研究使用一个大规模癌症数据库来确定台湾肺癌患者生存的预后因素。
分析了总共24910例被诊断为肺癌的患者。采用Kaplan-Meier方法进行生存估计。Cox比例风险模型估计各种预后因素的死亡风险（风险比（HR））。
与肺癌死亡风险较高相关的预后指标包括男性（男性与女性相比；HR = 1.07，95%置信区间（CI）：1.03 - 1.11）、在较晚时期被诊断出的男性（1991 - 1994年与1987 - 1990年相比；HR = 1.13）、诊断时年龄较大、大细胞癌（LCC）/小细胞癌（SCC）以及支持性护理治疗而非化疗。肺癌死亡的总体5年生存率男性（21.3%）显著低于女性（23.6%）。鳞状细胞癌（SQCC）且仅接受手术切除治疗的患者预后较好。我们发现手术切除显著提高了LCC的5年生存率，降低了LCC的死亡风险，而SCC的生存率没有改善。
性别和临床特征（即诊断时期、诊断年龄、组织学类型和治疗方式）在决定肺癌生存方面起着重要作用。
