Caballero Vázquez Alberto, García Flores Paula, Romero Ortiz Ana, Del Moral Raimundo García, Alcázar-Navarrete Bernardino
Servicio de Neumología, Hospital Universitario Virgen de las Nieves, Granada, Spain.
UGC de Anatomía Patológica, Complejo Hospitalario Universitario de Granada, Granada, Spain.
J Thorac Dis. 2018 Sep;10(9):5468-5475. doi: 10.21037/jtd.2018.08.49.
Non-small cell lung cancer (NSCLC) is a leading cause of death all over the world. Diagnostic and therapeutic arsenals have improved in recent years, but we are unsure as to whether these advances have been transferred to clinical practice. The aim of this study was to evaluate differences in NSCLC diagnostic processes and short-term survival rates between two recent cohorts.
A prospective, observational study was conducted with patients diagnosed with NSCLC in the period of 2011-2016. Patients were divided into two cohorts (2011-2013 and 2014-2016), and monitored for up to 1 year after diagnosis.
A total of 713 patients with lung cancer were selected, 500 of whom had NSCLC (222 patients in the 2011-2013 cohort, and 278 in the 2014-2016 cohort). We observed a chronological increase in the use of endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) and ultrasound-guided transthoracic puncture (US-TTP) between the cohorts. Overall short-term survival was similar between the two groups, both for locally and for advanced disease. Treatment with tyrosine kinase inhibitors (TKI) was the only therapeutic factor associated with an improved likelihood of survival.
Changes in diagnostic process in NSCLC have been observed towards a more precise stratification. Although short-term survival has not changed for advanced NSCLC, some of the newer therapeutic options are associated with increased survival in real-world scenarios.
非小细胞肺癌（NSCLC）是全球主要的死亡原因之一。近年来，诊断和治疗手段有所改进，但我们不确定这些进展是否已应用于临床实践。本研究的目的是评估两个近期队列之间NSCLC诊断过程和短期生存率的差异。
对2011年至2016年期间诊断为NSCLC的患者进行了一项前瞻性观察研究。患者被分为两个队列（2011 - 2013年和2014 - 2016年），并在诊断后监测长达1年。
共选取713例肺癌患者，其中500例为NSCLC（2011 - 2013年队列中有222例患者，2014 - 2016年队列中有278例）。我们观察到两个队列之间经支气管超声引导针吸活检（EBUS - TBNA）和超声引导下经胸穿刺活检（US - TTP）的使用呈逐年增加趋势。两组的总体短期生存率相似，无论是局部疾病还是晚期疾病。使用酪氨酸激酶抑制剂（TKI）治疗是唯一与生存可能性提高相关的治疗因素。
已观察到NSCLC诊断过程的变化朝着更精确的分层发展。虽然晚期NSCLC的短期生存率没有变化，但一些较新的治疗选择在实际临床中与生存率提高相关。
