Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, (L-5) 2-2 Yamadaoka, Suita, Osaka, Japan.
J Thorac Oncol. 2010 Sep;5(9):1369-75. doi: 10.1097/JTO.0b013e3181e452b9.
PURPOSE: To investigate prognoses of lung cancer patients prospectively enrolled in the Japan Lung Cancer Registry Study. METHODS: Patients newly diagnosed as having lung cancer exclusively in 2002 were enrolled. Follow-up surveys were performed twice, in 2004 and 2009, and the final follow-up data with prognoses were analyzed for 14,695 patients (79%). Clinical stages were defined according to the sixth edition of the International Union Against Cancer--tumor, node, metastasis classification (2002). RESULTS: The mean age was 67.1 years (range, 18-89 years), and there were 10,194 men (69.3%) and 4315 women (29.7%). The most frequent histology was adenocarcinoma (n = 8325, 56.7%), followed by squamous cell carcinoma (n = 3778, 26%) and small cell carcinoma (n = 1345, 9.2%). The distribution of clinical stages was as follows: IA, 4245 cases (29.3%); IB, 2248 (14.5%); IIA, 208 (1.4%); IIB, 918 (6.3%); IIIA, 1700 (11.8%); IIIB, 2110 (16.3%); and IV, 3037 (21.0%). The 5-year survival rates were 44.3% for all patients, 46.8% for those with non-small cell lung cancer, and 14.7% for those with small cell lung cancer. According to the clinical stage of non-small cell lung cancer and small cell lung cancer, the 5-year survival rates were 79.4 and 52.7% for stage IA, 56.9 and 39.3% for IB, 49.0 and 31.7% for IIA, 42.3 and 29.9% for IIB, 30.9 and 17.2% for IIIA, 16.7 and 12.4% for IIIB, and 5.8 and 3.8% for IV, respectively. CONCLUSION: Analysis of a large cohort in the Japanese registry study found that stage-specific prognosis was within a range similar to other reports. The data presented should provide an important reference for future clinical trials in Japan.
目的:前瞻性调查纳入日本肺癌注册研究的肺癌患者的预后情况。
方法:仅纳入 2002 年新诊断为肺癌的患者。于 2004 年和 2009 年进行了两次随访调查,并对 14695 例(79%)患者的最终随访数据和预后进行了分析。临床分期根据国际抗癌联盟第 6 版肿瘤、淋巴结、转移分类(2002 年)定义。
结果:患者平均年龄为 67.1 岁(范围 18-89 岁),其中 10194 例为男性(69.3%),4315 例为女性(29.7%)。最常见的组织学类型为腺癌(n=8325,56.7%),其次为鳞状细胞癌(n=3778,26%)和小细胞癌(n=1345,9.2%)。临床分期分布如下:IA 期 4245 例(29.3%);IB 期 2248 例(14.5%);IIA 期 208 例(1.4%);IIB 期 918 例(6.3%);IIIA 期 1700 例(11.8%);IIIB 期 2110 例(16.3%);IV 期 3037 例(21.0%)。所有患者的 5 年生存率为 44.3%,非小细胞肺癌患者为 46.8%,小细胞肺癌患者为 14.7%。根据非小细胞肺癌和小细胞肺癌的临床分期,IA 期的 5 年生存率分别为 79.4%和 52.7%,IB 期为 56.9%和 39.3%,IIA 期为 49.0%和 31.7%,IIB 期为 42.3%和 29.9%,IIIA 期为 30.9%和 17.2%,IIIB 期为 16.7%和 12.4%,IV 期为 5.8%和 3.8%。
结论:日本注册研究的大样本队列分析发现,特定分期的预后与其他报告中的范围相似。本研究结果可为日本未来的临床试验提供重要参考。
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