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欧洲肺癌风险模型在日本人群中的验证:对612例病例的回顾性单中心分析。

Validation of Eurolung risk models in a Japanese population: a retrospective single-centre analysis of 612 cases.

作者信息

Nagoya Akihiro, Kanzaki Ryu, Kanou Takashi, Ose Naoko, Funaki Soichiro, Minami Masato, Shintani Yasushi, Tsutsui Anna, Suga Sayaka, Tajima Tetsuya, Ohno Yuko, Okumura Meinoshin

机构信息

Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.

Department of Mathematical Health Science, Osaka University Graduate School of Medicine, Suita, Japan.

出版信息

Interact Cardiovasc Thorac Surg. 2019 Nov 1;29(5):722-728. doi: 10.1093/icvts/ivz171.

Abstract

OBJECTIVES

The objective of this study was to evaluate the validity of Eurolung risk models in a Japanese population and assess their utility as predictive indicators for the prognosis.

METHODS

Between 2007 and 2014, 612 anatomic lung resections were performed among 694 lung cancer patients in our institution. We analysed the cardiopulmonary morbidity and mortality and compared them with the predicted results. We also investigated the association between the Eurolung aggregate risk scores and the long-term outcomes using the Kaplan-Meier method and a multivariable analysis.

RESULTS

The percentage of cardiopulmonary complications was lower than that predicted by Eurolung 1 (22.4% vs 24.6%). The mortality rate was significantly lower than predicted by Eurolung 2 (0.7% vs 3.0%). The morbidity rate was stratified by Aggregate Eurolung 1. The stratification of the mortality rate by the Eurolung 2 aggregate score was also in line with the increase in score, although the observed number of deaths was quite small (4 cases). The 5-year overall survival was clearly separated according to the stratified Aggregate Eurolung 1 and 2 (P < 0.01 and P < 0.01, respectively). Besides pathological stage, both the Aggregate Eurolung 1 (score 0-7 vs 8-20) and 2 (score 0-8 vs 9-19) scores were shown to be independently associated with overall survival on multivariable.

CONCLUSIONS

Eurolung risk models cannot be directly applied to the patients in our institution. However, Eurolung aggregate risk scores were helpful not only for stratifying morbidity and mortality after anatomic lung resection but also for predicting the long-term outcomes.

摘要

目的

本研究的目的是评估欧洲肺癌风险模型在日本人群中的有效性,并评估其作为预后预测指标的实用性。

方法

2007年至2014年期间,我们机构对694例肺癌患者进行了612例解剖性肺切除术。我们分析了心肺发病率和死亡率,并将其与预测结果进行比较。我们还使用Kaplan-Meier方法和多变量分析研究了欧洲肺癌综合风险评分与长期结局之间的关联。

结果

心肺并发症的发生率低于欧洲肺癌风险模型1预测的发生率(22.4%对24.6%)。死亡率显著低于欧洲肺癌风险模型2预测的死亡率(0.7%对3.0%)。发病率按欧洲肺癌综合风险模型1进行分层。欧洲肺癌风险模型2综合评分对死亡率的分层也与评分增加一致,尽管观察到的死亡病例数很少(4例)。根据欧洲肺癌综合风险模型1和2的分层,5年总生存率有明显差异(分别为P < 0.01和P < 0.01)。除病理分期外,多变量分析显示欧洲肺癌综合风险模型1(评分0 - 7对8 - 20)和2(评分0 - 8对9 - 19)的评分均与总生存独立相关。

结论

欧洲肺癌风险模型不能直接应用于我们机构的患者。然而,欧洲肺癌综合风险评分不仅有助于对解剖性肺切除术后的发病率和死亡率进行分层,还有助于预测长期结局。

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