Department of Thoracic Surgery, Ningbo No. 2 Hospital, Zhejiang Province, P.R. China.
Oncol Res. 2019 Feb 5;27(2):203-210. doi: 10.3727/096504018X15202953107093. Epub 2018 Mar 9.
The purpose of this study was to determine the effects of resection coupled with standard chemotherapy on the survival prognosis of patients with early stage small cell lung carcinoma (SCLC). Patients ( = 110) with mediastinal lymph node-negative SCLC were enrolled in this study. The baseline clinical data of patients with surgery were retrospectively reviewed. Overall survival (OS) and progression-free survival (PFS) were measured by Kaplan-Meier and log-rank test analyses. Ninety-eight patients received mediastinoscopy biopsy, and pulmonary lobectomy or sublobar resection, and 67 patients underwent adjuvant chemotherapy after pulmonary lobectomy. Adjuvant chemotherapy after surgical intervention was associated with longer OS (median OS: 42.14 vs. 33.53 months, = 0.01) and PFS (median PFS: 25.20 vs. 13.48 months, = 0.000) compared to resection alone for all patients. Adjuvant chemotherapy was associated with improvement of survival for N1 patients with stage II (median OS: 36.42 vs. 26.68 months, = 0.021). The median PFS was 19.02 m (16.08, 21.96) and 13.25 m (10.19, 16.30) ( = 0.031), respectively, for patients of N1 stage who received chemotherapy and those who did not. Cox regression analysis demonstrated that age, TNM stage (N stage, not T stage), and chemotherapy were independent risk factors that might affect overall survival in patients with mediastinal lymph node-negative SCLC. These findings suggest that the application of adjuvant chemotherapy following pulmonary lobectomy is associated with improvements of survival prognoses for patients with SCLC. The combination of surgical intervention with conventional therapy should be taken into consideration as a prospective multidisciplinary regimen for early stage SCLC.
本研究旨在探讨切除术联合标准化疗对纵隔淋巴结阴性小细胞肺癌（SCLC）患者生存预后的影响。纳入了 110 例纵隔淋巴结阴性 SCLC 患者，回顾性分析了手术患者的基线临床资料。采用 Kaplan-Meier 和对数秩检验分析总生存（OS）和无进展生存（PFS）。98 例患者接受了纵隔镜活检和肺叶切除术或亚肺叶切除术，67 例患者在肺叶切除术后接受了辅助化疗。与单纯手术相比，手术干预后辅助化疗可延长所有患者的 OS（中位 OS：42.14 比 33.53 个月， = 0.01）和 PFS（中位 PFS：25.20 比 13.48 个月， = 0.000）。对于 II 期 N1 患者，辅助化疗可改善生存（中位 OS：36.42 比 26.68 个月， = 0.021）。接受化疗的 N1 期患者的中位 PFS 为 19.02 m（16.08，21.96），未接受化疗的患者为 13.25 m（10.19，16.30）（ = 0.031）。Cox 回归分析表明，年龄、TNM 分期（N 分期，而非 T 分期）和化疗是影响纵隔淋巴结阴性 SCLC 患者总体生存的独立危险因素。这些发现表明，肺叶切除术后应用辅助化疗可改善 SCLC 患者的生存预后。将手术干预与常规治疗相结合，应作为早期 SCLC 的一种有前途的多学科治疗方案。
