Hjelde Harald, Sundstrøm Stein, Ødegård Asbjørn, Hatlinghus Staal, Abusland Anne Britt, Haaverstad Rune
Lungeavdelingen, St. Olavs hospital, 7006 Trondheim, Norway.
Tidsskr Nor Laegeforen. 2010 Jan 14;130(1):25-8. doi: 10.4045/tidsskr.09.0689.
2500 new cases of lung cancer are diagnosed in Norway annually. Patients with limited disease can be operated, but many will die from the disease despite surgical treatment. The aim of the study was to review survival and recurrence, and factors which affect survival, in patients operated for lung cancer.
The risk of death and recurrence of disease was assessed retrospectively in patients who had non-small lung cancer and were operated at St. Olavs University Hospital, Trondheim in the period 1994-2001. Patient data were retrieved from medical records and a database with records from thoracosurgical procedures.
190 patients (30 % women) were included in the study. Average observation time after surgery was 58.3 months (range 21-99). Adenocarcinoma was the most common histological cancer type and occurred in 57.9 % of women and 39.1 % of the men (p = 0.02). The 30-day mortality rate was 3.2 % and the 60-day rate was 4.7 %. Recurrence of the disease was found in 45.8 %, among them median time to recurrence was 9 months after the operation. 5-year survival was 42 %, as analysed by the Kaplan-Meier estimate, and survival was best for early stages of the disease. 5-year survival was better for women (53.3 %) than men (36.8 %), p = 0.05. Prognostic factors for survival, estimated by Hazard ratio for death with Cox multiple regression analysis, were sex, age at the time of operation, type of operation, tumour diameter and postoperative N-stage.
Postoperative mortality and survival corresponded to data in the literature. Early stage lung cancer can be cured with surgical treatment. Our study confirms an increase in the incidence of adenocarcinoma among lung cancer patients during the last decades. Female sex is a positive prognostic factor for survival, as is young age, small tumor size, standard lobectomy, and absence of lymph node metastases.
挪威每年有2500例新发肺癌病例。疾病局限的患者可以接受手术治疗，但许多患者尽管接受了手术治疗仍会死于该疾病。本研究的目的是回顾接受肺癌手术患者的生存率、复发情况以及影响生存的因素。
对1994年至2001年期间在特隆赫姆市圣奥拉夫大学医院接受非小细胞肺癌手术的患者的死亡风险和疾病复发情况进行回顾性评估。患者数据从病历和一个包含胸外科手术记录的数据库中获取。
190名患者（30%为女性）纳入研究。术后平均观察时间为58.3个月（范围21 - 99个月）。腺癌是最常见的组织学癌症类型，在女性中占57.9%，在男性中占39.1%（p = 0.02）。30天死亡率为3.2%，60天死亡率为4.7%。45.8%的患者出现疾病复发，其中复发的中位时间为术后9个月。通过Kaplan-Meier估计分析，5年生存率为42%，疾病早期的生存率最佳。女性的5年生存率（53.3%）高于男性（36.8%），p = 0.05。通过Cox多元回归分析估计的死亡风险比来确定生存的预后因素，包括性别、手术时年龄、手术类型、肿瘤直径和术后N分期。
术后死亡率和生存率与文献数据相符。早期肺癌可以通过手术治疗治愈。我们的研究证实了过去几十年肺癌患者中腺癌发病率的增加。女性性别是生存的一个积极预后因素，年轻、肿瘤小、标准肺叶切除术以及无淋巴结转移也是如此。
