Peng Hong, Ma Meili, Han Baohui
Outpatient Office, Shanghai Chest Hospital, Shanghai, China.
Zhongguo Fei Ai Za Zhi. 2011 Apr;14(4):362-6. doi: 10.3779/j.issn.1009-3419.2011.04.11.
At present non-small cell lung cancer (NSCLC) is still the leading cause of death induced by cancer. The aim of this study is to investigate the prognostic factors of advanced NSCLC.
Total 1,742 cases of stage IV NSCLC data from Jan 4, 2000 to Dec 25, 2008 in Shanghai Chest Hospital were collected, confirmed by pathological examinations. Analysis was made to observe the impact of treatment on prognosis in gender, age, smoking history, pathology, classification, clinical TNM stage. Survival rate, survival difference were evaluated by Kaplan-Meire method and Logrank test respectively. The prognosis were analyzed by Cox multivariate regression.
The median survival time of 1,742 patients was 10.0 months (9.5 months-10.5 months). One, two, three, four, and five-year survival rates were 44%, 22%, 13%, 9%, 6% respectively. The median survivals of single or multiple metastasis were 11 months vs 7 months (P < 0.001). Survival time were different in metastasic organs, with the median survival time as follows: lung for about 12 months (11.0 months-12.9 months), bone for 9 months (8.3 months-9.6 months), brain for 8 months (6.8 months-9.1 months), liver, adrenal gland, distant lymph node metastasis for 5 months (3.8 months-6.1 months), and subcutaneous for 3 months (1.7 months-4.3 months). The median survival times of adenocarcinoma (n=1,086, 62%) and squamous cell carcinoma cases (n=305, 17.5%) were 12 months vs 8 months (P < 0.001). The median survival time of chemotherapy and best supportive care were 11 months vs 6 months (P < 0.001); the median survival times of with and without radiotherapy were 11 months vs 9 months (P=0.017).
Gender, age, gross type, pathological type, clinical T stage, N stage, numbers of metastatic organ, smoking history, treatment of advanced non-small cell lung cancer were independent prognostic factors.
目前，非小细胞肺癌（NSCLC）仍是癌症致死的主要原因。本研究旨在探讨晚期NSCLC的预后因素。
收集2000年1月4日至2008年12月25日上海胸科医院1742例IV期NSCLC患者的数据，均经病理检查确诊。分析性别、年龄、吸烟史、病理类型、分类、临床TNM分期等因素对治疗预后的影响。分别采用Kaplan-Meire法和Logrank检验评估生存率及生存差异。通过Cox多因素回归分析预后情况。
1742例患者的中位生存时间为10.0个月（9.5个月 - 10.5个月）。1年、2年、3年、4年和5年生存率分别为44%、22%、13%、9%、6%。单发或多发转移患者的中位生存期分别为11个月和7个月（P < 0.001）。不同转移器官的生存时间不同，中位生存时间如下：肺转移约12个月（11.0个月 - 12.9个月），骨转移9个月（8.3个月 - 9.6个月），脑转移8个月（6.8个月 - 9.1个月），肝、肾上腺、远处淋巴结转移5个月（3.8个月 - 6.1个月），皮下转移3个月（1.7个月 - 4.3个月）。腺癌（n = 1086，62%）和鳞状细胞癌（n = 305，17.5%）患者的中位生存时间分别为12个月和8个月（P < 0.001）。化疗和最佳支持治疗患者的中位生存时间分别为11个月和6个月（P < 0.001）；接受和未接受放疗患者的中位生存时间分别为11个月和9个月（P = 0.017）。
性别、年龄、大体类型、病理类型、临床T分期、N分期、转移器官数量、吸烟史、晚期非小细胞肺癌的治疗是独立的预后因素。
