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非小细胞肺癌患者的术后随访

Postoperative follow-up for patients with non-small cell lung cancer.

作者信息

Nakamura Ryota, Kurishima Koichi, Kobayashi Naohiro, Ishikawa Shigemi, Goto Yukinobu, Sakai Mitsuaki, Onizuka Masataka, Ishikawa Hiroichi, Satoh Hiroaki, Hizawa Nobuyuki, Sato Yukio

机构信息

Division of Thoracic Cardiovascular Surgery, University of Tsukuba, Ibaraki, Japan.

出版信息

Onkologie. 2010;33(1-2):14-8. doi: 10.1159/000264623. Epub 2010 Jan 22.

Abstract

BACKGROUND

It is unclear whether postoperative follow-up by thoracic surgeons or chest physicians for non-small cell lung cancer (NSCLC) alters survival.

PATIENTS AND METHODS

The charts of 1,398 NSCLC patients, diagnosed between 1980 and 2008, were reviewed. Prognostic factors contained therein were evaluated using univariate and multivariate analyses. Patients were divided into 2 groups according to the doctor in charge of their postoperative follow-up: the thoracic surgeon group and the chest physician group. The doctors in charge of following up the patients were also analyzed for prognostic significance.

RESULTS

In the univariate and multivariate analyses, age 65 years or younger, female sex, early pathological stage, Charlson Index score of 0-1, absence of adjuvant therapy, and follow-up by a chest physician were significantly favorable prognostic factors. Examined overall, NSCLC patients in the chest physician group had longer survival than those in the thoracic surgeon group. The difference in survival of patients with advanced disease was also statistically significant between these 2 groups.

CONCLUSIONS

Our results indicate that early detection of asymptomatic disease by regular follow-up including chest computed tomography scan may improve the chance of treatment with curative intent and thus may increase survival, irrespective of the doctor in charge of follow-up.

摘要

背景

对于非小细胞肺癌(NSCLC)患者,由胸外科医生或胸科医生进行术后随访是否会改变生存率尚不清楚。

患者与方法

回顾了1980年至2008年间确诊的1398例NSCLC患者的病历。使用单因素和多因素分析评估其中包含的预后因素。根据术后随访的负责医生将患者分为两组:胸外科医生组和胸科医生组。还分析了负责随访患者的医生的预后意义。

结果

在单因素和多因素分析中,年龄65岁及以下、女性、早期病理分期、Charlson指数评分为0 - 1、未进行辅助治疗以及由胸科医生进行随访是显著有利的预后因素。总体来看,胸科医生组的NSCLC患者生存期长于胸外科医生组。这两组中晚期疾病患者的生存差异也具有统计学意义。

结论

我们的结果表明,通过包括胸部计算机断层扫描在内的定期随访早期发现无症状疾病,可能会提高根治性治疗的机会,从而可能提高生存率,无论负责随访的医生是谁。

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