Liu Huihui, Xu Yan, Wang Mengzhao, Hu Ke, Ma Manjiao, Zhong Wei, Zhang Li, Zhao Jing, Li Longyun, Wang Huazhu
Department of Respiratory Medicine, Peking Union Medical College Hospital, Beijing 100730, China.
Zhongguo Fei Ai Za Zhi. 2013 Nov;16(11):596-602. doi: 10.3779/j.issn.1009-3419.2013.11.06.
At present, surgery is advocated for stage IIIa non-small cell lung cancer (NSCLC), and the survival of them is determined by many factors. The aim of this study is to analyze the influencing factors of prognosis for stage IIIa surgical patients.
Between March 2002 and October 2012, 151 surgical cases that have postoperative pathological finding of stage IIIa NSCLC with completed followed-up data were received in the Peking Union Medical College Hospital. According to different N stages, 151 patients were divided into T4N0/T3-4N1M0 and T1-3N2M0 stages. Kaplan-Meier survival method was used to calculate the overall survival (OS) and progression-free survival (PFS), and to proceed univariate analysis of survival. Cox regression analysis was used to conduct multivariate analysis. A p-value less than 0.05 was evaluated as statistically significant.
151 stage IIIa NSCLC patients had 43 stage T4N0/T3-4N1M0 cases and 108 stage T1-3N2M0 cases. The median OS and PFS of the whole group were 38.9 and 12.9 months respectively. The median OS of stage T4N0/T3-4N1M0 and T1-3N2M0 were 48.7 and 38.9 months. The median PFS of them were 14.9 and 19.8 months respectively. There were no significant differences of OS and PFS between two groups. Univariate and multivariate analysis indicated that postoperative chemotherapy had a significant influence on OS of the surgical patients with stage IIIa NSCLC (P=0.001), and family history of tumor had a significant influence on PFS (P<0.05). The maximum diameter of tumor had a significant influence on PFS only in univariate analysis.
For stage IIIa NSCLC, postoperative chemotherapy can increase OS and PFS, but postoperative radiotherapy have no benefit on them.
目前,Ⅲa期非小细胞肺癌(NSCLC)提倡手术治疗,其生存受多种因素影响。本研究旨在分析Ⅲa期手术患者预后的影响因素。
2002年3月至2012年10月,北京协和医院收治151例术后病理确诊为Ⅲa期NSCLC且随访资料完整的手术病例。根据不同N分期,将151例患者分为T4N0/T3 - 4N1M0期和T1 - 3N2M0期。采用Kaplan - Meier生存法计算总生存期(OS)和无进展生存期(PFS),并进行生存单因素分析。采用Cox回归分析进行多因素分析。p值小于0.05被评估为具有统计学意义。
151例Ⅲa期NSCLC患者中,T4N0/T3 - 4N1M0期43例,T1 - 3N2M0期108例。全组患者的中位OS和PFS分别为38.9个月和12.9个月。T4N0/T3 - 4N1M0期和T1 - 3N2M0期的中位OS分别为48.7个月和38.9个月。它们的中位PFS分别为14.9个月和19.8个月。两组间OS和PFS无显著差异。单因素和多因素分析表明,术后化疗对Ⅲa期NSCLC手术患者的OS有显著影响(P = 0.001),肿瘤家族史对PFS有显著影响(P < 0.05)。肿瘤最大径仅在单因素分析中对PFS有显著影响。
对于Ⅲa期NSCLC,术后化疗可提高OS和PFS,但术后放疗对其无益处。