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[ⅢA-N2期非小细胞肺癌根治性手术的预后分析]

[Prognostic analysis of curative surgery for stage IIIA-N2 non-small cell lung cancer].

作者信息

Liu Jing-wei, Li Jian, Lin Gang, Shang Xue-qian

机构信息

Department of Thoracic Surgery, Peking University First Hospital, Beijing, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2013 Jan;35(1):50-3. doi: 10.3760/cma.j.issn.0253-3766.2013.01.011.

DOI:10.3760/cma.j.issn.0253-3766.2013.01.011
PMID:23648301
Abstract

OBJECTIVE

To investigate the survival and prognostic factors in patients undergoing potentially curative resection of stage IIIA-N2 non-small cell lung cancer.

METHODS

Clinical data of eighty-nine patients, who underwent curative operation from January 2003 to April 2007 in the Peking University First Hospital and were pathologically diagnosed as stage IIIA-N2 NSCLC, were reviewed. The patients were followed up until death or the cut-off date. The overall 3-year and 5-year survival rates were calculated, and Cox proportional hazard model was used to determine the clinical and pathological risk factors and evaluate their influence on the survival.

RESULTS

The three-year and five-year survival rates were 51.7% and 31.5%, respectively. The univariate Cox regression analysis revealed five significant factors associated with prognosis: the arm of age < 55, T3 stage, lymphovascular invasion (LVI), multiple positive N2 station and the number of positive N2 nodes > 3 were found to be at increased risk of tumor-related death, and those risk factors were confirmed especially in the age ≥ 55 group. Multivariate Cox regression analysis indicated three independent prognostic factors: T3 stage, LVI and multiple positive N2 station.

CONCLUSIONS

The results of this preliminary study show that T3 stage, lymphovascular invasion and N2 level (single or multiple station) are associated with the prognosis of stage IIIA-N2 NSCLC patients after potentially curative resection, and the characteristics of age < 55 and the number of positive N2 nodes > 3 may imply worse prognosis.

摘要

目的

探讨接受潜在根治性切除的IIIA-N2期非小细胞肺癌患者的生存情况及预后因素。

方法

回顾性分析2003年1月至2007年4月在北京大学第一医院接受根治性手术且病理诊断为IIIA-N2期非小细胞肺癌的89例患者的临床资料。对患者进行随访直至死亡或截止日期。计算总体3年和5年生存率,并采用Cox比例风险模型确定临床和病理风险因素并评估其对生存的影响。

结果

3年和5年生存率分别为51.7%和31.5%。单因素Cox回归分析显示与预后相关的5个显著因素:年龄<55岁、T3期、淋巴管浸润(LVI)、多个阳性N2站以及阳性N2淋巴结数目>3被发现肿瘤相关死亡风险增加,且这些风险因素在年龄≥55岁组中尤为明显。多因素Cox回归分析表明3个独立预后因素:T3期、LVI和多个阳性N2站。

结论

这项初步研究结果表明,T3期、淋巴管浸润和N2水平(单站或多站)与IIIA-N2期非小细胞肺癌患者潜在根治性切除后的预后相关,年龄<55岁和阳性N2淋巴结数目>3的特征可能预示预后较差。

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