50 岁以下肺癌患者的临床病理特征和手术结果：日本肺癌登记研究 2004 年报告。

Clinicopathological characteristics and surgical results of lung cancer patients aged up to 50 years: the Japanese Lung Cancer Registry Study 2004.

机构信息

Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.

出版信息

Lung Cancer. 2014 Feb;83(2):246-51. doi: 10.1016/j.lungcan.2013.11.007. Epub 2013 Nov 17.

DOI:10.1016/j.lungcan.2013.11.007

PMID:24296124

Abstract

OBJECTIVE

The clinicopathological characteristics and surgical results of young lung cancer patients were investigated.

MATERIALS AND METHODS

Seven hundred and four (6.0%) patients with lung cancer, aged up to 50 years, were enrolled from among the 11,663 patients registered in the Japanese Lung Cancer Registry Study 2004, and their clinical data were compared with those of 10,959 patients older than 50 years. This epidemiological study is based on the single year registration of surgically treated patients in the major institutes in Japan.

RESULTS

The 5-year overall survival rate (5Y-OS) and the 5-year lung cancer-related survival rate was 79.2%/69.0% (p<0.001) and 81.3%/76.6% (p=0.005) in the young/old groups, respectively. In the young/old groups, lobectomy and pneumonectomy was performed in 76.9%/78.0% and 5.7%/3.2%, respectively; adjuvant therapies were given preoperatively in 10.4%/4.7% (p<0.001) and postoperatively in 31.4%/24.5% (p<0.001). The proportions of patients with p-stage IIIA (18.2%) and adenocarcinoma histology (78.7%) were higher in the young group. The 5Y-OS was 94.8%/86.2% for p-stage IA (p<0.001), 87.0%/73.2% for p-stage IB (p=0.001), 61.0%/61.6% for p-stage IIA (p=0.595), 71.0%/48.4% for p-stage IIB (p=0.003), 49.6%/39.4% for p-stage IIIA (p=0.020), and 80.0%/24.8% for p-stage IIIB (p=0.012); it was 83.5%/80.7% for females (p=0.106) and 75.1%/62.3% for males (p<0.001) in the young/old groups. The postoperative survival was significantly better with all operative procedures in the young group. The 5Y-OS after recurrence was 17.9%/13.4% in the young/old groups (p=0.016). In the young group, the 5Y-OS was better in females (83.5%) than in males (75.1%, p=0.002), and for patients with adenocarcinoma (80.3%) than for those with squamous cell carcinoma (68.5%, p=0.013). Age up to 50 years was identified as an independent better prognostic factor on multivariate analysis.

CONCLUSIONS

The postoperative survival in lung cancer patients aged up to 50 years was better than that in patients older than 50 years.

摘要

目的

研究年轻肺癌患者的临床病理特征和手术结果。

材料和方法

从日本肺癌登记研究 2004 年登记的 11663 例患者中纳入了 704 例（6.0%）年龄在 50 岁以下的肺癌患者，并与年龄大于 50 岁的 10959 例患者的临床数据进行了比较。这项流行病学研究基于日本主要机构中接受手术治疗的患者的单一年度登记。

结果

年轻/老年组的 5 年总生存率（5Y-OS）和 5 年肺癌相关生存率分别为 79.2%/69.0%（p<0.001）和 81.3%/76.6%（p=0.005）。在年轻/老年组中，行肺叶切除术和全肺切除术的比例分别为 76.9%/78.0%和 5.7%/3.2%；术前和术后分别给予辅助治疗的比例分别为 10.4%/4.7%（p<0.001）和 31.4%/24.5%（p<0.001）。年轻组的 p 期 IIIA（18.2%）和腺癌组织学（78.7%）的比例更高。p 期 IA（p<0.001）、p 期 IB（p=0.001）、p 期 IIA（p=0.595）、p 期 IIB（p=0.003）、p 期 IIIA（p=0.020）和 p 期 IIIB（p=0.012）的 5Y-OS 分别为 94.8%/86.2%、87.0%/73.2%、61.0%/61.6%、71.0%/48.4%、49.6%/39.4%和 49.6%/39.4%；女性的 5Y-OS 分别为 83.5%/80.7%（p=0.106），男性的 5Y-OS 分别为 75.1%/62.3%（p<0.001）。年轻组的所有手术术后生存均显著改善。年轻/老年组的术后复发 5Y-OS 分别为 17.9%/13.4%（p=0.016）。在年轻组中，女性（83.5%）的 5Y-OS 优于男性（75.1%，p=0.002），腺癌（80.3%）的 5Y-OS 优于鳞状细胞癌（68.5%，p=0.013）。年龄至 50 岁被确定为多因素分析中的独立预后较好的因素。