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非小细胞肺癌肺寡转移的外科治疗

Surgical treatment in non-small cell lung cancer with pulmonary oligometastasis.

作者信息

He Jinyuan, Li Yun, An Jun, Hu Liu, Zhang Junhang

机构信息

Department of Cardiothoracic Surgery, The 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

出版信息

World J Surg Oncol. 2017 Feb 2;15(1):36. doi: 10.1186/s12957-017-1105-8.

Abstract

BACKGROUND

Previous studies have demonstrated survival benefits for local treatment in solitary metastatic non-small cell lung cancer (NSCLC).This study aimed to investigate the effect of local surgery for NSCLC with pulmonary oligometastasis.

METHODS

This study included 21 patients of NSCLC with pulmonary oligometastasis between January 2003 and December 2013, which were divided into two groups, group A (11 cases) for local surgery and group B (10 cases) for systematic chemotherapy, compared the median survival time (MST) and 5-year survival rate between the two groups, and analyzed the impact of the pathological types, the TNM and pN stage of primary tumor, the site, and the mode and number of oligometastatic nodule on group A.

RESULTS

The MST of group A and B were 37 and 11.6 months respectively, 5-year survival rates were 18.2 and 9.1% respectively (p < 0.05). Patients with single nodule, oligo-recurrence, primary tumor of pN0, TNM stage I or II obtained higher survival rate than those with multiple nodules, sync-oligometastases, pN1-2, stage III or IV in group A (p < 0.05). There was no significant survival time difference among pathological types of primary tumor and oligometastatic site (p > 0.05).

CONCLUSION

Local surgery significantly prolonged the overall survival time and 5-year survival rate of primary NSCLC with pulmonary oligometastasis.

摘要

背景

既往研究已证实局部治疗对孤立性转移性非小细胞肺癌(NSCLC)具有生存获益。本研究旨在探讨局部手术治疗肺寡转移NSCLC的效果。

方法

本研究纳入2003年1月至2013年12月期间的21例肺寡转移NSCLC患者,分为两组,A组(11例)接受局部手术,B组(10例)接受全身化疗,比较两组的中位生存时间(MST)和5年生存率,并分析A组患者的病理类型、原发肿瘤的TNM和pN分期、部位以及寡转移结节的模式和数量的影响。

结果

A组和B组的MST分别为37个月和11.6个月,5年生存率分别为18.2%和9.1%(p<0.05)。A组中,单结节、寡复发、pN0原发肿瘤、TNMⅠ或Ⅱ期患者的生存率高于多结节、同步寡转移、pN1-2、Ⅲ或Ⅳ期患者(p<0.05)。原发肿瘤的病理类型和寡转移部位之间的生存时间无显著差异(p>0.05)。

结论

局部手术显著延长了肺寡转移原发性NSCLC的总生存时间和5年生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86c4/5288889/f1fcf3f3b762/12957_2017_1105_Fig1_HTML.jpg

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