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肺黏液表皮样癌的手术治疗结果:41例病例回顾

Surgical outcomes of pulmonary mucoepidermoid carcinoma: A review of 41 cases.

作者信息

Hsieh Chih-Cheng, Sun Yung-Han, Lin Shih-Wei, Yeh Yi-Chen, Chan Mei-Lin

机构信息

Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.

Institute of Clinical Medicine and Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan.

出版信息

PLoS One. 2017 May 2;12(5):e0176918. doi: 10.1371/journal.pone.0176918. eCollection 2017.

Abstract

INTRODUCTION

Pulmonary mucoepidermoid carcinoma is a rare cancer that occurs primarily in younger patients. The prognostic factors of pulmonary mucoepidermoid carcinoma are largely undetermined, especially in elderly patients. The aim of this study was to examine the clinical characteristics and prognostic factors influencing survival after surgical resection in patients with pulmonary mucoepidermoid carcinoma and also analyze the clinical manifestations and prognostic factors in elderly patients.

MATERIALS AND METHODS

The pathological records of 41 pulmonary mucoepidermoid carcinoma patients (mean age, 61.4 years) who underwent surgical resection at our hospital between January 1991 and July 2015 were retrospectively reviewed. Subjects >65 years of age (n = 22) were considered elderly.

RESULTS

The median follow-up duration was 42.9 (interquartile range, 15.0-120.8) months. Sixteen patients (39.0%) experienced tumor relapse, including 13 patients (81.3%) within 2 years. The 5-year disease-free survival rate was 57.9%. Tumor grade did not influence disease-free survival (P = 0.286). In the multivariate analysis, age, tumor size, pathological T3-4 status, and pathological N2 status were independent predictors of disease-free survival. The 5-year overall survival rate was 57.0%. Tumor grade also did not influence overall survival (P = 0.170). Age, tumor size, pathological T status, and pathological N2 status were independent predictors of overall survival. In elderly patients, the 5-year disease-free survival and overall survival rates were 41.4% and 41.5%, respectively. Pathological T status was the only independent predictor of both disease-free survival and overall survival in elderly patients.

CONCLUSIONS

Prognostic factors identified for pulmonary mucoepidermoid carcinoma in this study differ from those of previous studies. Principally, tumor grade did not influence either disease-free survival or overall survival. Age, tumor size, and pathological factors were independent predictors of disease-free survival and overall survival. In elderly patients, pathological T status was the only independent predictor of disease-free survival and overall survival.

摘要

引言

肺黏液表皮样癌是一种罕见的癌症,主要发生在年轻患者中。肺黏液表皮样癌的预后因素在很大程度上尚未确定,尤其是在老年患者中。本研究的目的是探讨肺黏液表皮样癌患者手术切除后的临床特征和影响生存的预后因素,并分析老年患者的临床表现和预后因素。

材料与方法

回顾性分析1991年1月至2015年7月在我院接受手术切除的41例肺黏液表皮样癌患者(平均年龄61.4岁)的病理记录。年龄>65岁的患者(n = 22)被视为老年患者。

结果

中位随访时间为42.9(四分位间距,15.0 - 120.8)个月。16例患者(39.0%)出现肿瘤复发,其中13例患者(81.3%)在两年内复发。5年无病生存率为57.9%。肿瘤分级不影响无病生存率(P = 0.286)。多因素分析显示,年龄、肿瘤大小、病理T3 - 4期状态和病理N2期状态是无病生存的独立预测因素。5年总生存率为57.0%。肿瘤分级也不影响总生存率(P = 0.170)。年龄、肿瘤大小、病理T期状态和病理N2期状态是总生存的独立预测因素。在老年患者中,5年无病生存率和总生存率分别为41.4%和41.5%。病理T期状态是老年患者无病生存和总生存的唯一独立预测因素。

结论

本研究确定的肺黏液表皮样癌预后因素与以往研究不同。主要是,肿瘤分级既不影响无病生存率也不影响总生存率。年龄、肿瘤大小和病理因素是无病生存和总生存的独立预测因素。在老年患者中,病理T期状态是无病生存和总生存的唯一独立预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d859/5413008/7371d39fc33b/pone.0176918.g001.jpg

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