Yue Dongsheng, Gong Liqun, You Jian, Su Yanjun, Zhang Zhenfa, Zhang Zhen, Gu Feng, Wang Meng, Wang Changli
Department of Lung Cancer, Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center of Cancer, Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, P,R, China.
BMC Cancer. 2014 Jun 10;14:422. doi: 10.1186/1471-2407-14-422.
To compare survival of patients with non-small cell lung cancer (NSCLC) who underwent surgical resection and lymph node sampling based on guidelines proposed by the American College of Surgeons Oncology Group (ACOSOG), National Comprehensive Cancer Network (NCCN), the OSI Pharmaceutical RADIANT trial, and the International Association for the Study of Lung Cancer (IASLC).
Medical records of patients with NSCLC who underwent surgical resection from 2001 to 2008 at our hospital were reviewed. Staging was according to the 7th edition of the AJCC TNM classification of lung cancer. Patients who received surgical resection following the IASLC, ACOSOG, RADIANT or NCCN resection criteria were identified.
A total of 2,711 patients (1803 males, 908 females; mean age, 59.6 ± 9.6 years) were included. Multivariate Cox proportional hazards regression analysis indicated that increasing age, adenosquamous histology, and TNM stage II or III were associated with decreased overall survival (OS). Univariate analysis and log-rank test showed that surgical resection following the guidelines proposed by the IASLC, NCCN, ACOSOG, or RADIANT trial was associated with higher cumulative OS rates (relative to resection not following the guidelines). Multivariate analysis revealed that there was a significant improvement in OS only when IASLC resection guidelines (complete resection) were followed (hazard ratio=0.84, 95% confidence interval 0.716 to 0.985, P=0.032).
Surgical resection following the criteria proposed by IASLC, NCCN, ACOSOG, or the RADIANT trial was associated with a higher cumulative OS rate. However, significant improvement in OS only occurred when IASLC resection guidelines were followed.
比较根据美国外科医师学会肿瘤学组（ACOSOG）、美国国立综合癌症网络（NCCN）、OSI制药公司的RADIANT试验以及国际肺癌研究协会（IASLC）提出的指南，接受手术切除和淋巴结采样的非小细胞肺癌（NSCLC）患者的生存率。
回顾了2001年至2008年在我院接受手术切除的NSCLC患者的病历。分期依据美国癌症联合委员会（AJCC）肺癌TNM分类第7版。确定了按照IASLC、ACOSOG、RADIANT或NCCN切除标准接受手术切除的患者。
共纳入2711例患者（男性1803例，女性908例；平均年龄59.6±9.6岁）。多变量Cox比例风险回归分析表明，年龄增加、腺鳞癌组织学类型以及TNM分期II期或III期与总生存期（OS）降低相关。单变量分析和对数秩检验显示，按照IASLC、NCCN、ACOSOG或RADIANT试验提出的指南进行手术切除与更高的累积OS率相关（相对于未遵循指南的切除）。多变量分析显示，仅在遵循IASLC切除指南（完全切除）时，OS有显著改善（风险比=0.84，95%置信区间0.716至0.985，P=0.032）。
按照IASLC、NCCN、ACOSOG或RADIANT试验提出的标准进行手术切除与更高的累积OS率相关。然而，仅在遵循IASLC切除指南时，OS才有显著改善。
